Objective To explore the efficacy of the Levetiracetam treatment of Electrical Status Epilepticusin in Sleep(ESES). Methods Totally 50 cases of epilepsy children with ESES were treated with Levetriacetam add-on therapy (13 cases) and monotherapy (37 cases).The clinical seizures,long-term video EEG and intelligence were observed before and after therapy to analyse the eliminate of the ESES,the controlling of the role of clinical seizures,and the influence of Levetiracetam on the cognition. Results 2 cases were lost to follow-up,48 cases were finished at least 1 year of follow-up.The seizures of 29 patients were completely controlled,8 cases reduced more than 50%,11 cases were invalided.The clinical effective rate was 77.1%,the reduce of more than 75% of Spike Wave Index (SWI) were 14 cases (29.2%),that of more than 50% of SWI were 11 cases(22.9%),the total effective rate was 52.1%.There were no significant difference on the operation ability,verbal ability and total IQ before and after treatment.The effective rate of the treatment of atypical benign epilepsy with central and temporary (ABECT) was 69.6%,significantly higher than other syndromes. Conculsions Levetiracetam is efficient and safety.Long-term treatment of levetiracetam has no cognitive impairment of the children.Levetiracetam is more efficient to patients with ABECT than other epileptic syndrome.
Key words
epilepsy /
electrical status epilepticus in sleep /
Levetiracetam /
clinical efficiency
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
References
[1] Schmitt B.Sleep and epilepsy syndromes[J].Neuropediatrics,2015; 46:171-180.
[2] Degerliyurt A,Yalnizoglu D,Bakar EE,et al.Electrical status epilepticus during sleep:a study of 22 patients[J].Brain Dev,2015,37:250-264.
[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,1971,24:242-252.
[4] Chen J,Cai F,Jiang L,et al.Levetiracetam efficacy in children with epilepsy with electrical status epilepticus in sleep[J].Epilepsy Behav,2015,44:73-77.
[5] Van den Munckhof B,van Dee V,Sagi L,et al.Treatment of electrical status epilepticus in sleep:A pooled analysis of 575 cases[J].Epilepsia,2015,56:1738-1746.
[6] Reyes G,Flesler S,Armeno M,et al.Ketogenic diet in patients with epileptic encephalopathy with electrical status epilepticus during slow sleep[J].Epilepsy Res,2015,113:126-131.
[7] Chen XQ,Zhang WN,Yang ZX,et al.Efficacy of levetiracetam in electrical status epilepticus during sleep of children:a multicenter experience[J].Pediatr Neurol,2014,50:243-249.
[8] Bjornaes H,Bakke KA,Larsson PG,et al.Subclinical epileptiform activity in children with electrical status epilepticus during sleep:effects on cognition and behavior before and after treatment with levetiracetam[J].Epilepsy Behav,2013,27:40-48.
[9] 杨志仙,刘晓燕,等.左乙拉西坦对伴睡眠中癫痫性电持续状态癫痫患儿的疗效[J].实用儿科临床杂志 2010,25(12):937-939.
[10] Uliel-Sibony S,Kramer U.Benign childhood epilepsy with Centro-Temporal spikes (BCECTSs),electrical status epilepticus in sleep (ESES),and academic decline--how aggressive should we be?[J].Epilepsy Behav,2015,44:117-120.