左乙拉西坦治疗2岁以下婴幼儿癫痫有效性及安全性研究

目的 评估2岁以下癫痫婴幼儿应用左乙拉西坦(LEV)的疗效及安全性,为临床有效防治提供参考依据。方法 对2010年1月-2011年12月西安交通大学第二附属医院儿科神经专科住院确诊的2岁以下癫痫患儿中,服用LEV的39例患儿进行临床分析,收集患儿发作类型、家族史、影像学等资料,并进行为期6~72个月的随访,评估患儿治疗情况、疗效及不良反应等。结果 左乙拉西坦单药治疗终量有82.7%的患儿为中低剂量,添加治疗剂量组70%的患儿为高剂量。左乙拉西坦治疗2 岁以下癫痫患儿,6个月总有效率为82.1%,完全控制率为61.5%。其中,对于局灶性发作、强直阵挛发作有效率分别为76%和55.6%,对于失张力及肌阵挛发作效果差。单药及添加治疗的不良反应发生率均较低,提示左乙拉西坦具有较高安全性。结论 左乙拉西坦是一种广谱有效的抗癫痫药物,作为单药治疗或添加治疗对部分或全面性发作均具有良好疗效,具有较高的耐受性及保留率,是2岁内儿童癫痫一种有益的选择。

Study on the effectiveness and safety of Levetiracetam in the treatment of epilepsy in infants under 2 years old

Objective To evaluate the efficacy and safety of levetiracetam used in the infants of epilepsy under 2 years old. Methods A total of 39 patients who were diagnosed with epilepsy,under the age of 2,taken the levetiracetam,hospitalized in pediatric neurological from January 2010 to December 2011 were retrospectively evaluated.Seizure type,family history and imaging were collected.Patients were followed up for 6~72 months to evaluate the treatment condition,efficacy and adverse reactions. Results The treatment dosage in monotherapy group was mainly given as a lower dosage (82.7%),while that in add-on therapy group was mainly in high doses (70%).After 6 months' follow-up,the total effective rate was 82.1%,and the total control rate was 61.5%.Among them,the efficacy rates in focal seizure and the tonic-clonic seizure were 76% and 55.6%.The levetiracetam may be useless on the atonic seizure and myoclonic seizure.Also,the adverse reactions rarely occurred,suggesting that the levetiacetam was safe. Conclusion Levetiracetam is a broad-spectrum antiepileptic drug and has high tolerance and retention rate.It is promising to be a helpful choice for the epilepsy children within 2 years old.