Fayyazi Afshin, Ebrahimi Mohammad Hossein, Roshanaei Ghodratollah, Bazmamoun Hassan
Department of pediatric neurology, Hamadan University of Medical Sciences, Hamadan, Iran.
Pediatrician, department of pediatrics, Hamadan University of Medical Sciences, Hamadan, Iran.
Iran J Child Neurol. 2021 Fall;15(4):67-73. doi: 10.22037/ijcn.v16i1.30946.
Epilepsy is a relatively common disease in childhood. In some patients, the electroencephalogram (EEG) is abnormal despite the clinical control of seizures. Studies have identified the adverse effects of epileptic discharges on cognition, learning, behavior, and seizure recurrence in children. This study investigated the Levetiracetam effect on epileptic discharges in the interictal phase of EEG in epileptic children.
MATERIALS & METHODS: This clinical trial was conducted on 54 epileptic children aged 2 to 15 years, whose clinical seizures were controlled by sodium valproate in the last six months but still had epileptic discharges in EEG. The participants were divided into two groups: an intervention group (21 people), for which Levetiracetam was added to sodium valproate, and a control group (33 people), for which treatment with sodium valproate alone was continued. The patients were then followed for one year.
The percent normalization of epileptic discharges in the intervention and control groups was 66.7% and 57.1% (P = 0.500), respectively. Also, the mean time for the normalization of epileptic discharges in the intervention and control groups was 12.60±8.25 and 20.57±12.67 months ( = 0.042), respectively.
In children with controlled seizures whose EEG was still abnormal, sodium valproate therapy alone and combined with Levetiracetam effectively reduced the severity of epileptic discharges. However, the addition of Levetiracetam to sodium valproate normalized EEG more rapidly.
癫痫是儿童期相对常见的疾病。在一些患者中,尽管癫痫发作在临床上得到了控制,但脑电图(EEG)仍显示异常。研究已经确定癫痫放电对儿童认知、学习、行为和癫痫复发的不良影响。本研究调查了左乙拉西坦对癫痫儿童脑电图发作间期癫痫放电的影响。
本临床试验对54名年龄在2至15岁的癫痫儿童进行,这些儿童在过去六个月中临床癫痫发作由丙戊酸钠控制,但脑电图仍有癫痫放电。参与者被分为两组:干预组(21人),在丙戊酸钠基础上加用左乙拉西坦;对照组(33人),继续单独使用丙戊酸钠治疗。然后对患者进行一年的随访。
干预组和对照组癫痫放电正常化的百分比分别为66.7%和57.1%(P = 0.500)。此外,干预组和对照组癫痫放电正常化的平均时间分别为12.60±8.25个月和20.57±12.67个月(P = 0.042)。
在癫痫发作得到控制但脑电图仍异常的儿童中,单独使用丙戊酸钠治疗以及联合左乙拉西坦均可有效降低癫痫放电的严重程度。然而,在丙戊酸钠基础上加用左乙拉西坦能使脑电图更快恢复正常。