左乙拉西坦对儿童睡眠中癫癎性电持续状态的影响

张玮娜; 邹丽萍; 鞠俊; 李晓燕

PDF(952 KB)

中国当代儿科杂志 ›› 2012, Vol. 14 ›› Issue (5) : 340-343.

论著·临床研究

左乙拉西坦对儿童睡眠中癫癎性电持续状态的影响

张玮娜，邹丽萍，鞠俊，李晓燕

作者信息 +

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

ZHANG Wei-Na, ZOU Li-Ping, JU Jun, LI Xiao-Yan

Author information +

文章历史 +

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.

导出引用

张玮娜，邹丽萍，鞠俊，李晓燕. 左乙拉西坦对儿童睡眠中癫癎性电持续状态的影响[J]. 中国当代儿科杂志. 2012, 14(5): 340-343

ZHANG Wei-Na, ZOU Li-Ping, JU Jun, LI Xiao-Yan. Therapeutic effects of levetiracetam on electrical status epilepticus during sleep in children[J]. Chinese Journal of Contemporary Pediatrics. 2012, 14(5): 340-343

中图分类号： R748

参考文献

［1］Galanopoulou AS, Bojko A, Lado F, Moshé SL. The spectrum of neuropsychiatric abnormalities associated with electrical status epilepticus in sleep［J］. Brain Dev, 2000, 22(5): 279-295.

［2］Capovilla G, Beccaria F, Cagdas S, Montagnini A, Segala R, Paganelli D. Efficacy of levetiracetam in pharmacoresistant continuous spikes and waves during slow sleep［J］. Acta Neurol Scand, 2004, 110(3): 144-147.

［3］Patry G, Lyagoubi S, Tassinari CA. Subclinical "electrical status epilepticus" induced by sleep in children. A clinical and electroencephalographic study of six cases［J］. Arch Neurol, 1971, 24(3): 242-252.

［4］Pina-Garza JE, Nordli DR Jr, Rating D, Yang H,Schiemann-Delgado J, Duncan B, et al. Adjunctive levetiracetam in infants and young children with refractory partial-onset seizures［J］. Epilepsia, 2009, 50(5): 1141-1149.

［5］Wheless JW, Ng YT. Levetiracetam in refractory pediatric epilepsy［J］. J Child Neurol, 2002, 17(6): 413-415.

［6］Aeby A, Poznanski N, Verheulpen D, Wetzburger C, Van Bogaert P. Levetiracetam efficacy in epileptic syndromes with continuous spikes and waves during slow sleep: experience in 12 cases［J］. Epilepsia, 2005, 46(12): 1937-1942.

［7］Kramer U, Sagi L, Goldberg-Stern H, Zelnik N, Nissenkorn A, Ben-Zeev B.Clinical spectrum and medical treatment of children with electrical status epilepticus in sleep (ESES)［J］. Epilepsia, 2009, 50(6): 1517-1524.

［8］Briggs DE, French JA. Levetiracetam safety profiles and tolerability in epilepsy patients［J］. Expert Opin Drug Saf, 2004, 3(5): 415-424.

［9］Grosso S, Franzoni E, Coppola G, Iannetti P, Verrotti A, Cordelli DM, et al. Efficacy and safety of levetiracetam:an add-on trial in children with refractory epilepsy［J］. Seizure, 2005, 14(4), 248-253.

［10］Guerrini R, Belmonte A, Genton P. Antiepileptic drug-induced worsening of seizures in children ［J］. Epilepsia, 1998, 39(Suppl 3): s2-s10.

［11］Inutsuka M, Kobayashi K, Oka M, Hattori J, Ohtsuka Y. Treatment of epilepsy with electrical status epilepticus during slow sleep and its related disorders［J］. Brain Dev, 2006, 28(5): 281-286.

［12］De Negri M, Baglietto MG, Battaglia FM, Gaggero R, Pessagno A, Recanati L. Treatment of electrical of electrical status epilepticus by short diazepam(DZP) cycles after DZP rectal bolus test［J］. Brain Dev, 1995, 17(5): 330-333.

［13］Glauser TA. Topiramate in the catastrophic epilepsies of childhood ［J］. J Child Neurol, 2000, 15 (Suppl 1): 14-21.

［14］黄铁栓,朱金兰,胡雁,李冰,廖建湘. 甲基泼尼松龙冲击治疗Lennox-Gastaut综合征合并睡眠期癫癎性脑电持续状态［J］.中国当代儿科杂志，2005，6(3)：231-232.

［15］Zona C, Niespodziany I, Marchetti C, Klitgaard H, Bernardi G, Margineanu DG. Levetiracetam does not modulate neuronal voltage-gated Na+ and T-type Ca2+ currents［J］. Seizure, 2001, 10(4): 279-286.

［16］Rigo JM, Hans G, Nguyen L, Rocher V, Belachew S, Malgrange B, et al. The anti-epileptic drug levetiracetam reverses the inhibition by negative allosteric modulators of neuronal GABA-and glycine-gated currents［J］. Br J Pharmacol, 2002, 136(5): 659-672.

［17］Glauser TA, Ayala R, Elterman RD, Mitchell WG, Van Orman CB, Gauer LJ, et al. Double-blind-placebo controlled trial of adjunctive levetiracetam in pediatric partial seizures［J］. Neurology, 2006, 66(11): 1654-1660.

［18］Perry S, Holt P, Benatar M. Levetiracetam versus carbamazepine monotherapy for partial epilepsy in children less than 16 years of age［J］. J Child Neurol, 2008, 23(5): 515-519.

［19］Kramer U, Sagi L, Goldberg-Stern H, Zelnik N, Nissenkorn A, Ben-Zeev B. Clinical spectrum and medical treatment of children with electrical status epilepticus in sleep (ESES)［J］. Epilepsia, 2009, 50(6): 1517-1524.

［20］Berkovic SF, Knowlton RC, Leroy RF, Schiemann J, Falter U; Levetiracetam N01057 Study Group. Placebo-controlled study of levetiracetam in idiopathic generalized epilepsy［J］. Neurology, 2007, 69(18): 1751-1760.

［21］Andermann E, Andermann F, Meyvish P, Tonner F. Efficacy and tolerability levetiracetam add-on therapy in patients with refractory idiopathic generalised epilepsy［J］. Epilepsia, 2006, 47: 187.

［22］Hirsch LJ, Arif H, Buchsbaum R, Weintraub D, Lee J, Chang JT, et a1. Effect of age and comedication on levetiracetam pharmacokineties and tolerability［J］. Epilepsia, 2007, 48(7): 1351-1359.