左乙拉西坦单药治疗癫癎患儿出现行为异常的气质与脑电特征分析  

Temperament Characteristics and Electroencephalogram Features of Epileptic Children with Behavioral Abnormalities Receiving Monotherapy of Levetiracetam

作　　者：张海燕[1] 甘斌[1] 刘义红[1] 刘贺临[1] 高琼[1] 

机构地区：[1]华中科技大学同济医学院附属孝感医院儿科,湖北孝感432000

出　　处：《实用儿科临床杂志》2011年第12期968-970,共3页Journal of Applied Clinical Pediatrics

摘　　要：目的通过分析经左乙拉西坦（LEV）治疗癫癎出现行为异常患儿的气质和脑电图,探讨左乙拉西坦治疗癫癎出现行为异常的特征。方法本院2008年12月-2010年10月诊断为癫癎的患儿126例,均给予LEV单药治疗,对癫癎患儿均采用相同的起始剂量,相同的间隔时间并按相同的公斤体质量加量,起始量10 mg.kg-1.d-1,2次.d-1,1周增加上述剂量1次,2~4周增加至维持剂量20~40 mg.kg-1.d-1,2次.d-1。通过电话跟踪随访,将出现兴奋、激惹、攻击、嗜睡等行为者共34例归为观察组,未出现行为异常者按1：1配对选出34例为对照组,对2组患儿进行气质测定,每个气质维度包括活动水平、节律性、趋避性、适应性、反应阈限、反应强度、心境、注意分散度和持久性,并分析患儿的脑电图。结果观察组患儿在反应强度、情绪本质等气质维度的得分较对照组患儿高,差异均有统计学意义（Pa〈0.01）。在活动水平、节律性、适应性、坚持性、注意分散度等方面差异无统计学意义。34例出现行为异常者均为局限性发作患儿,其中22例表现为额颞部异常放电。结论 LEV单药治疗癫癎患儿出现行为异常易发生在以额颞部异常放电的局限性发作患儿,并且该类患儿具有较强的反应强度及负性情绪。Objective To analyze the temperament characteristics and electroencephalogram（EEG） features of epileptic children with behavioral abnormalities who received levetiracetam therapy and explore the characteristics of their behavioral abnormalities after levetiracetam therapy accordingly.Methods One hundred and twenty-six children diagnosed as epilepsy from Dec.2008 to Oct.2010 were only given levetiracetam.All the patients were given the same initial dose with the same interval time,then the dose was added according to the same kilogram per-weight.The initial dose was 10 mg·kg-1·d-1 and 2 times everyday.Then all the patients were added with the above-mentioned dose one time every week up to 20-40 mg·kg-1·d-1 and 2 times everyday after 2 to 4 weeks.Thirty-four patients who had the behavioral abnormalities such as excitation,irritation,aggression,lethargy and so on were put into the observation group and according to one to one matching principle another 34 patients who didn′t have the behavioral abnormalities were put into the control group by phone interviews.Meanwhile the temperaments of the 2 groups including activity level,rhythmicity,phobotaxis,adaptability,threshold of response,response intensity,mental state,attention dispersibility and perseverance were determined and their individual electroencephalograms were analyzed.Results The scores of the response intensity and emotions entity of the observation group were higher than those in the control group and the differences were significant（Pa0.01）,but the differences between the activity level,rhythmicity,adaptability,perseverance and attention dispersibility were not significant.Thirty-four patients with behavioral abnormalities were partial seizures,of whom 22 patients had paradoxical discharge in the forehead and temporal region.Conclusions The behavioral abnormalities of the epileptic children who received levetiracetam therapy often occurred in the children with partial seizures who had paradoxical discharge in the forehead and temporal regio

关 键 词：左乙拉西坦 癫癎 行为 气质 脑电图 儿童 

分 类 号：R742.1[医药卫生—神经病学与精神病学]