左乙拉西坦对伴睡眠中癫性电持续状态癫患儿的疗效  

Therapeutic Effect of Levetiracetam for Epilepsy Combined with Electrical Status Epilepticus during Sleep in Children

作　　者：杨志仙[1] 刘晓燕[1] 秦炯[1] 张月华[1] 包新华[1] 熊晖[1] 王爽[1] 

机构地区：[1]北京大学第一医院儿科,北京100034

出　　处：《实用儿科临床杂志》2010年第12期937-939,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的探讨左乙拉西坦(LEV)对伴睡眠中癫性电持续状态(ESES)儿童癫的疗效。方法对14例癫儿童(男6例,女8例)在ESES时期给予LEV添加治疗(12例)或LEV单药治疗(2例),在治疗前后观察临床发作及视频脑电图(VEEG)情况,分析LEV在消除ESES现象、控制临床发作及改善认知方面的作用。结果起病年龄为1岁3个月～10岁。儿童良性癫伴中央颞区棘波(BECT)变异型10例,慢波睡眠期持续棘慢波综合征(CSWS)3例及Landau-Kleffner综合征(LKS)1例。LEV开始治疗年龄为3岁2个月～11岁3个月,随访时间为6～23个月。LEV对发作的疗效:显效1例,有效9例,无效4例,总有效率为71%,其中5例在随访3～6个月复发。LEV对VEEG的疗效:显效及有效各3例,无效8例,总有效率为42%,其中4例复发。激素治疗的总有效率和复发率分别为72%和50%。苯二氮类仅33%发作减少,SWI有短暂改善。LEV对BECT变异型的疗效优于对CSWS及LKS的疗效。结论 LEV在控制临床发作、消除ESES现象及改善认知方面有一定疗效。LEV疗效优于苯二氮类药物,与激素的疗效和复发率相当,但不良反应更少。Objective To investigate the therapeutic effect of levetiracetam（LEV） for epilepsy combined with electrical status epilepticus during sleep（ESES） in children.Methods During ESES period,14 patients（6 cases were male,8 cases were female） with epilepsy were treated by additive LEV（12 cases） or single LEV（2 cases）.The seizures and video electroencephalogram（VEEG） discharges were observed before and after LEV treatment.The efficacy of LEV on ESES suppression,seizure control and cognitive improvement were analyzed.Results Age of onset ranged from 1 year and 3 months to 10 years.The diagnosis of epilepsy syndrome included 10 patients with benign childhood epilepsy with centrotemporal spikes（BECT） variants,3 patients with continuous spike and waves during slow wave sleep syndrome（CSWS）,and 1 patient with Landau-Kleffner syndrome（LKS）.Age of onset LEV treatment ranged from 3 years and 2 months to 11 years and 3 months.The follow-up interval was 6-23 months.The efficacy of LEV on seizures showed prominent efficacious in 1 patient,efficacious in 9 patients and no efficacious in 4 patients,the effective rate was 71%.The seizures relapse in 5 patients during follow-up 3-6 months.The efficacy of LEV on VEEG： prominent efficacious in 3 patients and efficacious in 3 patients,the effective rate was 42%,of which 4 patients encountered recurrence,and no efficacious in 8 patients.The effective rate and relapse rate of corticosteroid were 72% and 50%.Transient efficacy of benzodiazepines had been found in 33% patients.The efficacy of LEV on BECT variant surpassed the efficacy on CSWS and LKS.Conclusions LEV had efficacy on seizure control,ESES suppression and cognitive improvement.The efficacy of LEV was surpassed than benzodiazepines,and its was equivalent to corticosteroid in the aspects of treatment and recurrence,but had a less side effect.

关 键 词：睡眠中癫性电持续状态 左乙拉西坦 脑电图描记术 

分 类 号：R742.1[医药卫生—神经病学与精神病学]