Han Min Jeong, Kim Sun Jun
Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Korea.
Research Institute of Clinical Medicine of Chonbuk National University, Chonbuk National University Medical School, Jeonju, Korea.
J Clin Neurol. 2018 Oct;14(4):523-529. doi: 10.3988/jcn.2018.14.4.523. Epub 2018 Sep 6.
This study is to assess the responsiveness of electroencephalography (EEG) abnormalities and their effects on language ability after initiating different types of antiepileptic therapy in children with newly diagnosed benign epilepsy of childhood with centrotemporal spikes (BECTS).
The records of patients newly diagnosed with BECTS (=120; 69 males) were reviewed retrospectively. The patients were randomly treated with lamotrigine, oxcarbazepine, or topiramate monotherapy, and underwent at least two EEG and standardized language tests. Effects were compared using Pearson's chi-square tests and paired -tests.
The recurrence rates for seizures in the lamotrigine, topiramate, and oxcarbazepine groups were 19.4%, 21.7%, and 11.4%, respectively, while complete or partial recovery (as indicated by EEG) occurred in 32%, 39%, and 16% of the patients. Patients in the lamotrigine group showed significant improvements in all parameters assessed by the Test of Language Problem Solving Abilities, except for 'determining cause.' Patients in the oxcarbazepine group also showed improvements, except for 'making inferences' (<0.05). Most linguistic index scores were worse in the topiramate group except for Mean Length of Utterance in Words. Patients in the lamotrigine and oxcarbazepine groups showed significant improvements in the receptive language test (<0.05). EEG improvements were not related to language ability.
The improvements in language and problem-solving performance in children with BECTS were greater for lamotrigine and oxcarbazepine than for topiramate. However, EEG remission did not imply that language function would be improved after the treatments.
本研究旨在评估新诊断为儿童中央颞区棘波良性癫痫(BECTS)的患儿在开始不同类型抗癫痫治疗后脑电图(EEG)异常的反应性及其对语言能力的影响。
回顾性分析新诊断为BECTS的患者(n = 120;69例男性)的记录。患者随机接受拉莫三嗪、奥卡西平或托吡酯单药治疗,并至少进行两次脑电图和标准化语言测试。使用Pearson卡方检验和配对检验比较疗效。
拉莫三嗪、托吡酯和奥卡西平组的癫痫复发率分别为19.4%、21.7%和11.4%,而32%、39%和16%的患者出现了完全或部分恢复(脑电图显示)。拉莫三嗪组患者在语言问题解决能力测试评估的所有参数中均有显著改善,但“确定原因”除外。奥卡西平组患者也有改善,但“进行推理”除外(P < 0.05)。托吡酯组除单词平均发音长度外,大多数语言指标得分较差。拉莫三嗪组和奥卡西平组患者在接受性语言测试中有显著改善(P < 0.05)。脑电图改善与语言能力无关。
拉莫三嗪和奥卡西平治疗的BECTS患儿在语言和解决问题能力方面的改善比托吡酯更大。然而,脑电图缓解并不意味着治疗后语言功能会得到改善。