奥卡西平联合左乙拉西坦治疗成人颞叶癫痫患者认知功能障碍的疗效观察

目的:观察奥卡西平联合左乙拉西坦治疗成人颞叶癫痫患者认知功能障碍的疗效。方法:根据设定的纳入与排除标准,收集2018年1月-2019年10月在昆明医科大学第一附属医院神经内科诊治的成人颞叶癫痫患者83例,按随机数字表法分为对照组(n=39例)和观察组(n=44)。对照组患者给予奥卡西平片,初始剂量为8～10 mg/(kg·d),分早、晚两次口服,然后根据患者具体情况每周增加5～10 mg/(kg·d),最大剂量不超过45 mg/(kg·d),以最低有效治疗剂量持续治疗3个月;观察组患者在对照组基础上加用左乙拉西坦片,起始治疗剂量为5～10 mg/(kg·d),分早、晚两次口服,根据患者的病情严重程度每周增加5～10mg/(kg·d),但总剂量不超过2 000 mg/d,以最低有效治疗剂量持续治疗3个月。测定两组患者治疗前后的Pz位点事件相关电位P300(包括N1、P2、N2、P3波的潜伏期和P3波的波幅),进行韦氏成人智力量表[WAIS-RC,包括分析语言智商(VIQ)、操作智商(PIQ)、总智商(FIQ)评分]和临床记忆量表[CMS,转化为记忆商(MQ)分值]测试,并记录不良反应发生...

Observation of Therapeutic Efficacy of Oxcarbazepine Combined with Levetiracetam in the Treatment of Cognitive Dysfunction in Adult Patients with Temporal Lobe Epilepsy

OBJECTIVE:To observe therapuetic efficacy of oxcarbazepine combined with levetiracetam in the treatment of cognitive dysfunction in adult patients with temporal lobe epilepsy.METHODS:According to inclusion and exclusion criteria,83 adult patients with temporal lobe epilepsy were collected from neurology department of the First Affiliated Hospital of Kunming Medical University during January 2018 to October 2019,and then divided into control group(39 cases)and observation group(44 cases).Control group was given Oxcarbazepine tablet with initial dose of 8-10 mg/(kg·d),morning and night,increased by 5-10 mg/(kg·d)each week according to patient’s condition,the maximal dose was 45 mg/(kg·d),lasting for 3 months with the lowest effective treatment dose.Based on treatment of control group,observation group was additionally given Levetiracetam tablet with initial dose of 5-10 mg/(kg·d),morning and night,increased by 5-10 mg/(kg·d)each week according to the severity of disease,the total dose was not more than 2000 mg/d,lasting for 3 months with the lowest effective treatment dose.The event-related potential P300 at Pz site in 2 groups was measured before and after treatment(including the incubation period of N1,P2,N2 and P3 waves,amplitude of P3 wave).Webster’s Adult Intelligence Scale[WAIS-RC,including verbal IQ(VIQ),performance IQ(PIQ),full scale IQ(FIQ)scores]and Clinical Memory Scale[CMS,converting to memory quotient(MQ)score]were adopted.The occurrence of ADR was recorded.RESULTS:Totally 5 patients of control group and 7 patients of observation group fell off.Finally,a total of 71 patients participated in the entire study(34 cases in control group and 37 cases in observation group).Before treatment,there was no statistical significance in P300 at Pz site,WAIS-RC and CMS between 2 groups(P>0.05).Compared with before treatment,incubation period of N2 and P3 waves was shortened significantly in 2 groups,and amplitude of P3 wave was increased significantly after treatment(P<0.05);VIQ,FIQ and MQ scores were increased significantly(P<0.05).The incubation period of P2 wave was shortened significantly,and PIQ score was increased significantly in observation group(P<0.05).Compared with control group,the shortening degree of incubation period of P2,P3 waves,rising degree of amplitude of P3 wave and rising degree of VIQ,PIQ,FIQ,MQ scores were more bigger after treatment in observation(P<0.05).In the control group,there was 1 case of slight rash,1 case of conscious asthenia;in the observation group,there was 1 case of nausea and vomiting,1 case of conscious asthenia,and 1 case of emotional instability;no serious ADR was found in 2 groups.CONCLUSIONS:Oxcarbazepine combined with levetiracetam can improve cognitive dysfunction in adult patients with temporal lobe epilepsy,and the treatment effect is significantly better than oxcarbazepine monotherapy.