Harbord Michael G
Paediatrics Department, Flinders Medical Centre, Bedford Park, South Australia, Australia.
J Paediatr Child Health. 2011 May;47(5):302-4. doi: 10.1111/j.1440-1754.2010.01950.x. Epub 2011 Jan 18.
To monitor the effect of adding levetiracetam in paediatric patients with hemiplegic cerebral palsy and uncontrolled epilepsy.
A case series of eight patients with hemiplegic cerebral palsy whose focal seizures were not adequately controlled by their current anticonvulsants were monitored after levetiracetam was added to their medications. If there was a 50% reduction in seizure frequency, then the other anticonvulsants were discontinued. Prolonged follow-up occurred for a minimum of 2 years.
There were seven males and one female whose ages ranged from 4 years to 17 years. All had focal onset seizures, while seven also had secondarily generalised tonic clonic seizures. Levetiracetam resulted in at least a 50% reduction in seizure frequency in seven, with no change in one. Three were able to wean successfully to monotherapy and remained seizure free for over 2 years. They had a prior history of infrequent seizures, one to six per year. Those who continued to require multiple anticonvulsants had a prior history of more frequent seizures, 6-50/year. Levetiracetam was well tolerated, and none ceased this because of side effects.
Levetiracetam is likely to be an effective anticonvulsant in children and adolescents with hemiplegic cerebral palsy and infrequent but persistent focal seizures.
监测添加左乙拉西坦对偏瘫型脑瘫且癫痫控制不佳的儿科患者的疗效。
对8例偏瘫型脑瘫患者进行病例系列研究，这些患者的局灶性癫痫发作未被当前抗惊厥药物充分控制，在其药物治疗中添加左乙拉西坦后进行监测。如果癫痫发作频率降低50%，则停用其他抗惊厥药物。进行了至少2年的长期随访。
有7名男性和1名女性，年龄在4岁至17岁之间。所有患者均有局灶性发作，其中7例还伴有继发性全面强直阵挛发作。左乙拉西坦使7例患者的癫痫发作频率至少降低了50%，1例无变化。3例患者成功减至单药治疗且2年多无癫痫发作。他们既往有癫痫发作不频繁的病史，每年1至6次。那些继续需要多种抗惊厥药物治疗的患者既往癫痫发作更频繁，每年6至50次。左乙拉西坦耐受性良好，无患者因副作用停药。
左乙拉西坦可能是治疗偏瘫型脑瘫且有不频繁但持续的局灶性癫痫发作的儿童和青少年的有效抗惊厥药物。
