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＆#183; d），分2次服用，2周后加服至30 mg（kg＆#183; d），维持剂量为30~40 mg（kg＆#183; 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＆lt;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＆lt;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。
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＆lt;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＆lt;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.
出处
《南方医科大学学报》
CAS
CSCD
北大核心
2014年第3期364-367,共4页
Journal of Southern Medical University
基金
国家自然科学基金(81071046)
广东省科技计划项目(2010B031600159)~~
关键词
额叶癫痫
左乙拉西坦
脑电图
临床发作
添加治疗
frontal lobe epilepsy
levetiracetam
electroencephalogram
seizure attacks
add-on therapy
