Posar Annio, Salerno Grazia G, Monti Morena, Santucci Margherita, Scaduto Maria C, Parmeggiani Antonia
IRCCS Institute of Neurological Sciences of Bologna, Bologna, Italy ; Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
Child Neurology Unit, S. Maria Nuova Hospital, Reggio Emilia, Italy.
J Pediatr Neurosci. 2014 May;9(2):115-20. doi: 10.4103/1817-1745.139282.
Levetiracetam (LEV) is an effective antiepileptic drug also used in childhood and adolescence. Literature data regarding the long-term effects of LEV in childhood epilepsy and based on extensive neuropsychological evaluations using standardized tools are still scanty. Our study aimed to address this topic.
We studied 10 patients with epilepsy characterized by focal or generalized seizures (4 boys, 6 girls; mean age: 10 years 8 months; range: 6 years 2 months - 16 years 2 months), treated with adjunctive LEV during a follow-up of 12 months. In 6 patients electroencephalogram (EEG) showed continuous spike and waves during sleep. Using standardized tools, we performed seriated assessments of cognitive and behavioral functioning in relation to seizure and EEG outcome.
Six patients completed the trial after 12 months of treatment; 1 patient dropped out of the study after 9 months, 3 patients after 6 months. Adjunctive LEV was effective on seizures in 3/10 patients and on EEG in 2/10 patients, and was well tolerated in all examined cases. Overall, no worsening of cognitive or behavioral functions has been detected during the period of the study; even at 6 and 12 months from baseline, an improvement in patients' abstract reasoning has been found, that was not related to seizure or EEG outcome.
In our population of children and adolescents, LEV had no adverse cognitive or behavioral effects, short- or long-term. We found an improvement of abstract reasoning, regardless of seizure and EEG outcome.
左乙拉西坦（LEV）是一种有效的抗癫痫药物，也用于儿童和青少年。关于LEV对儿童癫痫长期影响且基于使用标准化工具进行广泛神经心理学评估的文献数据仍然很少。我们的研究旨在解决这一课题。
我们研究了10例癫痫患者（4名男孩，6名女孩；平均年龄：10岁8个月；范围：6岁2个月 - 16岁2个月），在12个月的随访期间接受LEV辅助治疗。6例患者的脑电图（EEG）显示睡眠期间有持续性棘慢波。我们使用标准化工具，对与癫痫发作和EEG结果相关的认知和行为功能进行了系列评估。
6例患者在治疗12个月后完成试验；1例患者在9个月后退出研究，3例患者在6个月后退出。LEV辅助治疗对10例患者中的3例癫痫发作有效，对10例患者中的2例EEG有效，并且在所有检查病例中耐受性良好。总体而言，在研究期间未检测到认知或行为功能恶化；即使在基线后6个月和12个月时，也发现患者的抽象推理有所改善，这与癫痫发作或EEG结果无关。
在我们的儿童和青少年群体中，LEV无论短期还是长期均无不良认知或行为影响。我们发现无论癫痫发作和EEG结果如何，抽象推理都有所改善。
