左乙拉西坦对儿童睡眠中癫癎性电持续状态的影响

Therapeutic effects of levetiracetam on electrical status epilepticus during sleep in children

摘要:

目的：探讨左乙拉西坦（levetiracetam, LEV）治疗儿童睡眠中癫癎性电持续状态(ESES)的疗效。方法：对2009年8月至2011年3月首诊的27 例ESES患儿使用LEV状况进行分析，并最少随访6个月。结果：27例ESES患儿起病年龄为9个月至9岁7个月，起病早期81%的患儿为局限性运动发作。23例为ESES确诊后加用LEV治疗，其中19例为良性癫癎伴中央颞区棘波（BECT）患儿，4例为非BECT的ESES患儿。LEV 开始治疗年龄为1岁8个月至11岁9个月, 随访时间为7~19个月。LEV控制发作有效率为82%，改善脑电图（EEG）情况有效率为78%。LEV控制临床发作效果优于改善EEG效果（P<0.05）。另4例患儿于ESES前已加用LEV治疗,其中2例临床发作得到控制或EEG有明显改善。结论：LEV在控制临床发作和改善脑电图放电方面均有一定疗效。

Abstract:

OBJECTIVE: To study the efficacy of levetiracetam (LEV) in the treatment of electrical status epilepticus during sleep (ESES) in children. METHODS: The clinical data of 27 children who were newly diagnosed with ESES and treated with LEV between August 2009 and March 2011 and who were followed up for at least 6 months were retrospectively studied. RESULTS: The onset age of the 27 children ranged from 9 months to 9 years and 7 months. Partial motion seizures were found in 81% of the children in the early stage. Twenty-three children received LEV treatment after ESES was definitely diagnosed. Of the 23 children, 19 were diagnosed as epilepsy syndrome of benign childhood epilepsy with centrotemporal spikes (BECT). The age of the patients at the beginning of LEV treatment ranged from 1 year and 8 months to 11 years and 9 months. The follow- up duration was 7 to 19 months. The effective rate of LEV for seizure control was 82% and for EEG recovery it was 78% (P<0.05). The other 4 children received LEV treatment before the occurrence of ESES. Seizure control and EEG recovery were noted in two of the 4 children. CONCLUSIONS: LEV treatment is efficacious, to some extent, for both seizure control and EEG recovery in children with ESES.