Department of Pediatrics, Chinese PLA General Hospital, Beijing, 100853, China.
Ital J Pediatr. 2018 Jun 15;44(1):70. doi: 10.1186/s13052-018-0507-8.
In previous study, we have found intermittent oral levetiracetam (LEV) can effectively prevent recurrence of febrile seizure (FS). This study aimed to analyze the effects of the preventive on the patients with frequent FS accompanied with epileptiform discharge.
Patients with frequent FS were assigned to undergo Electroencephalogram (EEG). At the onset of fever, the patients who presented epileptiform discharge were orally administered with LEV with a dose of 15-30 mg/kg per day twice daily for 1 week, thereafter, the dosage was gradually reduced until totally discontinued in the second week. The seizure frequency associated with febrile events and FS recurrence rate during a 48-week follow-up were analyzed.
among the 19 patients presented epileptiform discharge on EEG, 31.58% (6 of 19) had complex FS, 68.42% (13 of 19) had simple FS. Up to 57.89% (11 of 19) had a family history of seizure disorder and 36.84% (7 of 19) had a family history of FS in first-degree relatives. 42.11% (8 of 19) happened the first FS episode at the age < 18 months. 36.84% (7/19) presented generalized spikes, 63.16% (12/19) showed focal spikes. During the 48-week follow-up period, the patients experienced 26 febrile episodes, none of them presented seizure recurrence.
Intermittent oral LEV can prevent the seizure recurrence of FS accompanied with epileptiform discharge in 48-week. However, further randomized controlled trials should be conducted.
ChiCTR-IPR-15007241 ; Registered 1 January 2014 - Retrospectively registered.
在之前的研究中，我们发现间歇性口服左乙拉西坦（LEV）可有效预防热性惊厥（FS）复发。本研究旨在分析预防性治疗对伴有癫痫样放电的频繁 FS 患者的影响。
频繁 FS 的患者进行脑电图（EEG）检查。发热时，出现癫痫样放电的患者给予 LEV 口服，剂量为 15-30mg/kg，每日两次，持续 1 周，然后逐渐减量，第二周停药。分析 48 周随访期间与发热事件相关的发作频率和 FS 复发率。
在 EEG 上出现癫痫样放电的 19 例患者中，31.58%（6/19）为复杂 FS，68.42%（13/19）为单纯 FS。57.89%（11/19）有癫痫发作家族史，36.84%（7/19）有一级亲属 FS 家族史。42.11%（8/19）首次 FS 发作年龄<18 个月。36.84%（7/19）表现为全面性棘波，63.16%（12/19）表现为局灶性棘波。在 48 周随访期间，患者共发生 26 次发热发作，均未出现惊厥复发。
间歇性口服 LEV 可预防伴有癫痫样放电的 FS 在 48 周内的复发。然而，还需要进一步的随机对照试验来验证。
ChiCTR-IPR-15007241；注册日期：2014 年 1 月 1 日-回顾性注册。
