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叶酸补充对长期接受抗癫痫治疗的癫痫儿童癫痫控制的影响。

Effect of Folic Acid Supplementation on Seizure Control in Epileptic Children Receiving Long Term Antiepileptic Therapy.

机构信息

Department of Pediatrics, Dr. S. N. Medical College, Jodhpur, Rajasthan, India.

Department of Pathology, Rog Nidan Seva Diagnostic Centre, Jodhpur, Rajasthan, India.

出版信息

Indian J Pediatr. 2018 Jul;85(7):493-497. doi: 10.1007/s12098-018-2608-1. Epub 2018 Jan 25.

Abstract

OBJECTIVE

To evaluate the effect of folic acid supplementation on seizure control in folate deficient children receiving long term antiepileptic therapy.

METHODS

In a prospective interventional study, 140 children between age group 6 mo to 180 mo fulfilling the inclusion criteria were enrolled in study group, from October 2015 through November 2016. On the basis of serum folate, study group was divided into two subgroups by non randomization: Group A (<10 ng/ml) given folic acid supplementation for 3 mo and Group B (>10 ng/ml) was not supplemented. Response to folic acid supplementation in group A was compared with group B in terms of change in blood folate levels, frequency and duration of seizures after three months.

RESULTS

Mean age of study group was 73.58 ± 46.89 mo (72.14% boys and 27.85% girls). 67.85% children were in group A and 32.14% in group B. On 3 mo follow up, children supplemented with folic acid (Group A) had significant fall in mean seizure frequency while in non-supplemented children (Group B), no significant change was seen (p value <0.05). Similar reduction in duration of seizure episode was seen in group A as compared to group B. Serum and RBC folate levels improved from baseline in group A, while in group B there was significant fall in folate levels.

CONCLUSIONS

Folate deficiency is common in epileptic children on long term antiepileptic drugs (AEDs), contributes to poor seizure control and should be considered in the etiologic differentials of drug resistant epilepsy. Folate supplementation improves seizure control in these children.

摘要

目的

评估补充叶酸对长期接受抗癫痫治疗的叶酸缺乏儿童的癫痫控制效果。

方法

在一项前瞻性干预研究中,纳入了 2015 年 10 月至 2016 年 11 月期间符合纳入标准的 140 名年龄在 6 个月至 180 个月之间的儿童,他们被分为研究组。根据血清叶酸水平,研究组通过非随机分组分为两个亚组:A 组(<10ng/ml)给予叶酸补充治疗 3 个月,B 组(>10ng/ml)不补充。比较 A 组补充叶酸前后血叶酸水平变化、癫痫发作频率和持续时间的变化,并与 B 组进行比较。

结果

研究组的平均年龄为 73.58±46.89 个月(72.14%为男孩,27.85%为女孩)。67.85%的儿童在 A 组,32.14%在 B 组。在 3 个月的随访中,补充叶酸的儿童(A 组)癫痫发作频率明显下降,而未补充叶酸的儿童(B 组)则没有明显变化(p<0.05)。与 B 组相比,A 组的癫痫发作持续时间也有所减少。与基线相比,A 组血清和红细胞叶酸水平有所改善,而 B 组叶酸水平则显著下降。

结论

长期服用抗癫痫药物(AEDs)的癫痫儿童中叶酸缺乏很常见,与癫痫控制不佳有关,应考虑将其作为耐药性癫痫的病因鉴别。补充叶酸可改善此类儿童的癫痫控制。

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