南方医科大学学报 ›› 2014, Vol. 34 ›› Issue (03): 364-.

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左乙拉西坦添加治疗小儿额叶癫痫:附105例报告

张宇昕,翟琼香,汤志鸿,卓木清   

  • 出版日期:2014-03-20 发布日期:2014-03-20

Therapeutic effect of levetiracetam add-on treatment for frontal lobe epilepsy in 105
children

  • Online:2014-03-20 Published:2014-03-20

摘要: 目的研究左乙拉西坦添加治疗伴有癫痫样放电的额叶癫痫患儿的24 h视频脑电图与临床改变。方法采用前瞻性研究,
本研究对长期服用1~2种抗癫痫药物治疗但仍伴有癫痫样放电的105例额叶癫痫患儿使用左乙拉西坦添加治疗,观察添加治疗
前后的24 h视频脑电图及临床发作的变化。左乙拉西坦起始剂量为20 mg(kg·d),分2次服用,2周后加服至30 mg(kg·d),维持
剂量为30~40 mg(kg·d)。对比左乙拉西坦添加前和添加6月后的24 h视频脑电图及临床发作,采用SPSS 19.0软件进行结果分
析。结果添加左乙拉西坦治疗后55 例患儿的癫痫样放电减少,有效率为52.3%。治疗前后脑电图的改变有统计学意义(P<
0.05)。77例伴有临床发作的患儿经添加治疗后临床发作完全控制12例,发作减少28例,总有效率51.9%,患儿临床发作的减少
与脑电图的好转呈正相关(P<0.001)。结论左乙拉西坦添加治疗脑电图有癫痫样放电的小儿额叶癫痫能同时减少癫痫样放电
和临床发作,且不良反应轻。

Abstract: Objective To study the changes in 24-hour video electroencephalogram (EEG) and epileptic attacks after
levetiracetam add-on therapy in children with frontal lobe epilepsy and epileptiform discharges. Methods A prospective study
was carried out in 105 children with the frontal lobe epilepsy who received long-term treatment with 1 or 2 types of
antiepileptic drug but still with epileptiform discharges in ECG. Levetiracetam add-on therapy was administered at the initial
daily dose of 20 mg/kg (given in 2 doses) for 2 weeks followed by an increase of the dose to 30 mg/kg with a maintenance dose
of 30-40 mg/kg. The changes in seizure attacks and 24-hour video-EEG monitoring after a 6-month therapy were observed.
Results Levetiracetam add-on therapy reduced epileptiform discharges in 55 children (52.3% ) and resulted in significant
changes in EEG (P<0.05). Of the 77 children with clinical seizures, complete seizure control was achieved in 12 cases after the
therapy, and the seizure attacks were reduced in 28 cases, showing a total response rate of 51.9%; the reduction in seizure
attacks was positively correlated with EEG improvement (P<0.001). Conclusion Levetiracetam add-on therapy can decrease
epileptiform discharges in EEG and reduce clinical seizure attacks in children with frontal lobe epilepsy with only mild
adverse reactions.