奥卡西平与拉考沙胺单药治疗伴中央颞区棘波的自限性癫痫的平行对照研究  

Aparallel controlled study on Oxcarbazepine and Lacosamide monotherapy for self-limited epilepsy with centro-temporal spikes

作　　者：仇莉 汤继宏[1] 张兵兵[1] 肖潇 杨乐天 徐欢 冯隽 王曼丽[1] QIU Li;TANG Jihong;ZHANG Binbin(Department of Neurology,Children's Hospital of Soochow University,Soochow 215025,China)

机构地区：[1]苏州大学附属儿童医院神经内科,215025 [2]徐州医科大学附属徐州儿童医院神经内科

出　　处：《临床神经病学杂志》2024年第6期441-446,共6页Journal of Clinical Neurology

基　　金：苏州市科技计划项目(SKY2022007)。

摘　　要：目的探讨奥卡西平(OXC)和拉考沙胺(LCM)单药治疗伴中央颞区棘波的自限性癫痫(SeLECTS)的临床疗效和耐受性,以及对EEG和认知功能的影响。方法收集2019年1月至2022年12月本院神经内科选择OXC或LCM单药治疗满3年的87例SeLECTS患儿的临床资料进行分析,比较两组患儿的3年无发作率、有效率及12个月缓解率、EEG和认知功能的变化及药物相关不良事件的发生情况。结果本研究共纳入87例SeLECTS患儿,OXC组47例,LCM组40例。在临床疗效和EEG改善方面,3年随访两组间差异无统计学意义。在认知方面,3年随访,两组全量程总智商、知觉推理指数、工作记忆指数、言语理解指数、加工速度指数均较治疗前明显提高(均P<0.05),两组间差异无统计学意义。在耐受性方面,OXC组和LCM组药物相关不良事件发生率的差异有统计学意义(38.30%vs.17.50%,P=0.033)。结论LCM单药治疗SeLECTS的疗效与OXC相似,能够有效控制癫痫发作,且具有更好的耐受性,可作为SeLECTS患儿单药治疗的首选药物之一。LCM对工作记忆的改善优于OXC,对知觉推理的改善较OXC体现更早。Objective To compare the clinical efficacy and tolerance of Oxcarbazepine(OXC)and Lacosamide(LCM)monotherapy for self-limited epilepsy with centro-temporal spikes(SeLECTS),as well as the effects on EEG and cognitive function.Methods Clinical data of 87 SeLECTS children who were treated with OXC or LCM monotherapy for 3 years in the Department of Neurology from January 2019 to December 2022 were collected for analysis.The 3-year seize-free rate,effective rate,12-month remission rate,changes in EEG and cognitive function and the occurrence of drug-related adverse events were compared between the two groups.Results A total of 87 SeLECTS children were included in this study,47 cases in the OXC group and 40 cases in the LCM group.In terms of efficacy and EEG,there was no significant difference between the two groups at 3 years follow-up.In terms of cognition,3-year follow-up,the full-scale total intelligence quotient,perceptual reasoning index,working memory index,verbal comprehension index and processing speed index of the two groups were significantly increased compared with that before treatment(all P<0.05),while there was no significant difference between the two groups.In terms of tolerance,there was a statistically significant difference in drug-related adverse events between the OXC group and LCM groups(38.30%vs.17.50%,P=0.033).Conclusions The efficacy of LCM monotherapy in the treatment of SeLECTS is similar to OXC,with effective seizure control and better tolerability.LCM can be one of the first choices for monotherapy in SeLECTS children.LCM improved working memory better and improved perceptual reasoning earlier than OXC.

关 键 词：奥卡西平 拉考沙胺 单药治疗 伴中央颞区棘波的自限性癫痫 

分 类 号：R742.1[医药卫生—神经病学与精神病学]