Abstract:

Objective　To investigate the efficacy of levetiracetam combined with sodium valproate in the treatment of benign epilepsy with centro-temporal spikes (BECT). Methods　A retrospective analysis was performed on 90 BECT children admitted to Weinan Maternal and Child Health Hospital from January 2020 to January 2023, and they were divided into a control group and an observation group with 45 cases in each group according to the treatment methods. In the control group, there were 25 boys and 20 girls, aged (7.52±1.68) years, with a disease course of (2.33±0.54) years. In the observation group, there were 24 boys and 21 girls, aged (7.49±1.71) years, with a disease course of (2.41±0.52) years. The control group was treated with sodium valproate oral solution, the initial dose was 20 mg/(kg·d), divided into 2 times; 1 week later, the dose was adjusted as needed, increasing by 5-10 mg/(kg·d) each time; after that, the dose was adjusted to 30-40 mg/(kg·d), once a day. The observation group was given levetiracetam oral solution on the basis of the control group, the initial dose was 10 mg/(kg·d), divided into 2 times; the dose was increased to 20 mg/(kg·d) in the second week; from the third week to the 24th week, the dose could be increased by 5-10 mg/kg per week up to 30-40 mg/(kg·d). The treatment period of both groups was 24 weeks. The efficacy and frequency of seizures, duration of seizures, and electroencephalographic (EEG) activity before and after treatment were compared between the two groups, and the incidence of adverse reactions was used to evaluate the safety. t test and χ² test were used. Results　After treatment, the total effective rate of the observation group was higher than that of the control group [97.78% (44/45) vs. 80.00% (36/45)] (P<0.05). After treatment, the frequency and duration of seizures of the observation group were (1.01±0.32) times/month and (7.61±1.84) min, which were lower than those of the control group [(1.46±0.47) times/month and (9.14±2.05) min] (both P<0.05). The frequency of α-band in the observation group was (35.46±3.47) Hz, which was higher than that in the control group [(33.01±3.32) Hz], but the frequencies of β-band [(7.14±1.05) Hz vs. (8.61±1.84) Hz], θ-band [(12.55±1.19) Hz vs. (14.92±1.88) Hz], and δ-band [(10.05±1.94) Hz vs. (12.26±2.08) Hz] were all lower than those in the control group (all P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion　In the treatment of BECT, levetiracetam combined with sodium valproate was more effective in improving the total effective rate, reducing the frequency of seizures, shortening the duration of seizures, and improving the EEG activity.

Key words:

Levetiracetam, Sodium valproate, Children, Benign epilepsy with centro-temporal spikes, Seizure characteristics, Safety

摘要：

目的　探讨左乙拉西坦联合丙戊酸钠治疗儿童自限性癫痫伴中央颞区棘波（benign epilepsy with centro-temporal spikes，BECT）的疗效。方法　回顾性分析2020年1月至2023年1月渭南市妇幼保健院收治的90例BECT患儿，根据治疗方法将其分为对照组与观察组各45例。对照组男25例，女20例，年龄（7.52±1.68）岁，病程（2.33±0.54）年；观察组男24例，女21例，年龄（7.49±1.71）岁，病程（2.41±0.52）年。对照组予以丙戊酸钠口服溶液治疗，起始剂量为20 mg/（kg·d），分2次服用；1周后，根据需要调整剂量，每次增加5～10 mg/（kg·d）；之后，调整为每日服用一次，剂量为30～40 mg/（kg·d）。观察组在对照组基础上予以左乙拉西坦口服溶液治疗，起始剂量为10 mg/（kg·d），分2次服用；第2周增加至20 mg/（kg·d）；从第3周起持续至24周，剂量可每周递增5～10 mg/kg，直至30～40 mg/（kg·d）。两组治疗周期均为24周。比较两组患儿的疗效及治疗前后的发作频率、发作持续时间、脑电活动情况，以不良反应发生率评估安全性。采用t检验、χ²检验。结果　治疗后观察组总有效率97.78%（44/45）高于对照组的80.00%（36/45）（P<0.05）。治疗后，观察组患儿的发作频率为（1.01±0.32）次/月、低于对照组的（1.46±0.47）次/月，发作持续时间为（7.61±1.84）min、短于对照组的（9.14±2.05）min（均P<0.05）。观察组的α波段频率为（35.46±3.47）Hz，高于对照组的（33.01±3.32）Hz，而β波段［（7.14±1.05）Hz比（8.61±1.84）Hz］、θ波段［（12.55±1.19）Hz比（14.92±1.88）Hz］、δ波段频率［（10.05±1.94）Hz比（12.26±2.08）Hz］均低于对照组（均P<0.05）。两组不良反应发生率差异无统计学意义（P>0.05）。结论　在BECT的治疗中，左乙拉西坦联合丙戊酸钠在提高总有效率、减少发作频率、缩短发作持续时间及改善脑电活动方面效果更佳。

关键词:

左乙拉西坦, 丙戊酸钠, 儿童, 自限性癫痫伴中央颞区棘波, 发作情况, 安全性