Moon Ja Un, Han Ji Yoon
Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea.
Department of Pediatrics, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul 06591, Korea.
Brain Sci. 2021 Oct 31;11(11):1452. doi: 10.3390/brainsci11111452.
Choosing optimal anti-seizure medication (ASM) is very important in pediatric patients with epilepsy who attend school, especially children with an intellectual disability (ID). Levetiracetam (LEV) has proven to be an effective, safe, generally well-tolerated, broad-spectrum ASM in children. In the context of increasing use of LEV in school-aged children with epilepsy and ID, we evaluate relevant clinical data, including efficacy, safety, and tolerability in children with epilepsy and an intellectual disability (ID) or normal intelligence (NI). We performed a retrospective chart review of children and included 298 pediatric patients with epilepsy who were treated with LEV with NI (147) and ID (151). After 6 months, 96% of NI and 83% of ID subjects had a seizure reduction rate greater than 50% ( 0.031). The tolerability of LEV was generally good, with 75% retention rates at 2 years in both groups and only minor side effects (under 15%). The retention rates of patients with NI and ID were 76% and 74%, respectively ( 0.597). Thus, LEV showed considerable efficacy with minimal side effects and high retention rates and is an easily maintained and safe treatment option for pediatric epilepsy with ID. However, better-designed research studies are needed to clearly elucidate the efficacy and safety of LEV in children with epilepsy and ID.
对于上学的癫痫患儿,尤其是智力残疾(ID)儿童,选择最佳抗癫痫药物(ASM)非常重要。左乙拉西坦(LEV)已被证明是一种对儿童有效、安全、耐受性良好的广谱抗癫痫药物。在癫痫和ID的学龄儿童中使用LEV的情况日益增加的背景下,我们评估了相关临床数据,包括癫痫合并智力残疾(ID)或智力正常(NI)儿童的疗效、安全性和耐受性。我们对儿童进行了回顾性病历审查,纳入了298例接受LEV治疗的癫痫患儿,其中NI组147例,ID组151例。6个月后,NI组96%和ID组83%的受试者癫痫发作减少率大于50%(P = 0.031)。LEV的耐受性总体良好,两组2年的保留率均为75%,且只有轻微副作用(低于15%)。NI组和ID组患者的保留率分别为76%和74%(P = 0.597)。因此,LEV显示出显著疗效,副作用最小,保留率高,是ID儿童癫痫易于维持且安全的治疗选择。然而,需要设计更完善的研究来明确LEV在癫痫合并ID儿童中的疗效和安全性。