吡仑帕奈添加治疗儿童及青少年难治性癫间的疗效及耐受性观察

Efficacy and Tolerability of Perampanel Addition in the Treatment of Refractory Epilepsy in Children and Adolescents

目的探讨吡仑帕奈添加治疗儿童及青少年难治性癫间(DRE)的疗效及不良反应。方法回顾性选取2020年6月至2021年12月接受吡仑帕奈添加治疗的98例DRE患儿为研究对象。根据脑电图表现及发作形式将患儿分组:局灶性发作组(43例)、全面性发作组(35例)和不能确定发作类型组(20例),比较添加吡仑帕奈治疗6个月和12个月的临床疗效和不良反应。结果添加吡仑帕奈治疗6个月和12个月后癫间控制有效率分别为58.16%和41.86%,总体保留率分别为87.86%和76.53%。局灶性发作组12个月治疗有效率为56.76%,全面性发作组12个月有效率为32.26%,不能确定发作类型组12个月有效率为27.78%。有31/98例(31.63%)患儿出现不良反应,随着用药时间推移大部分患儿均可耐受,仅3例患儿因不能耐受不良反应而停药。结论吡仑帕奈治疗儿童及青少年DRE疗效显著,在局灶性发作患儿中疗效更优,部分患儿存在相关不良反应,但因不良反应停药患儿较少。

Aim To explore the efficacy and adverse effects of perampanel addition for the treatment of refractory epilepsy in children.Method Ninety-eight children with drug-resistant epilepsy(DRE)treated with perampanel(PER)from June 2020 to December 2021 in the department of pediatric neurology of the Affiliated Hospital of Xuzhou Medical University were retrospectively selected for the study.Patients were divided into focal seizure,generalized seizure groups and subgroups in which the type of seizure could not be determined according to EEG presentation and seizure form,and the clinical efficacy and adverse effects were compared between 6 and 12 months of PER treatment.Results The seizure control efficiency at 6 and 12 months with the addition of PER treatment was 58.16%and 41.86%,respectively,and the overall retention rate was 87.86%and 76.53%,respectively.The 12-month treatment efficiency was 56.76%for 43 children in the focal seizure group,32.26%for 35 children in the generalized seizure group,and 27.78%for 20 children in the undetermined seizure type group.Adverse reactions were reported in 31 children(31.63%)and were tolerated by most of them over time,with only 3 children discontinuing the drug due to intolerable adverse reactions.Conclusion PER is effective in children and adolescents with DRE and is more effective in children with focal seizures,with some children having associated adverse effects,and fewer children discontinuing the drug due to adverse effects.