左乙拉西坦改善发作控制的癫痫患儿异常脑电图的疗效

Efficacy of levetiracetam on improving abnormal EEG in seizure-free epileptic children

目的探讨左乙拉西坦对临床发作缓解而脑电图明显异常的癫疴患儿的脑电图的影响。方法将就诊于我院神经专科门诊临床发作得到控制1年以上而脑电图依然明显异常的39例卡马西平单药治疗中的部分性或复杂部分性发作的癫痫患儿按来诊顺序交叉分为对照组、丙戊酸钠组及左乙拉西坦组，各13例。入组前半个月内均行脑电图检查，入组后分别予以维持原药治疗、加用丙戊酸钠口服及加用左乙拉西坦口服。观察时间6个月，6个月后复查脑电图，分析其疗效。结果3组患儿脑电图改善率（控制＋显效＋有效／总例数一失访人数）分别为9．1％、23．1％和66．7％；3组患儿脑电图改善率比较差异有统计学意义（P〈0．01），丙戊酸钠组与对照组比较差异无统计学意义（P〉0．0125），左乙拉西坦组与对照组比较差异有统计学意义（P〈0．0125）。结论添加左乙拉西坦可以有效减少癫痫患儿发作间期脑电图异常放电频率。

Objective This clinical study is aimed to investigate whether levetiracetam （LEV） can improve electrocorticogram （EEG） in epileptic children epilepsy patients with better clinical manifestation but abnormal EEG findings. Methods Totally 39 children from our neurological clinic with partial or com- plex partial epilepsy seizure were included in present study and assigned equally into three groups receiving different treatment： control group, sodium valproate （VPA） group, and LEV group. Their clinical symptoms had been controlled for over one year by carbamazepine （ CBZ）, but EEG results showed clearly abnormal. Epileptiform discharges were observed in routine EEG exams half a month before recruiting. After recruiting, they continued to receive CBZ alone （control group） or co-treated with VPA （VPA group） or LEV （LEV group）, respectively. Six months later, EEG was taken again and results were analyzed. Results Improve- ment rate were 9.1% （ control group） ,23.1% （ VPA group）, and 66.7 % （ LEV group）, respectively; Over- all statistical difference was reached among three groups （ P 〈 0. 01 ） and between control group and LEV group（ P 〈 0. 012 5 ）, but no statistical difference between control group and VPA group was reached （ P 〉 0. 012 5）. Conclusion Co-treatment of LEV in child epilepsy patients receiving CBZ can significantly de- crease abnormal EEG dischar~,e freouencv during interictal period.