摘要
目的探讨吡仑帕奈(PER)单药和添加治疗儿童癫痫伴睡眠中癫痫性电持续状态(ESES)的疗效,评估其安全性及对患儿认知功能的影响。方法选取35例癫痫伴ESES的患儿,按用药方式、添加PER次序、发作形式、癫痫综合征种类、头颅MRI有无异常分组。随访节点为用药后3个月、6个月、12个月,随访终点为用药后12个月。比较各组别加药前及加药后每个随访节点的发作频率、脑电图放电指数及认知功能,记录每个随访节点出现的不良事件,计算随访终点药物保留率,进而评估PER安全性。结果至随访终点,单药治疗组临床及ESES改善有效率均为80.0%,添加治疗组均为60.9%,两组有效率相比,差异无统计学意义(P>0.05)。首次添加组临床及ESES改善有效率均为83.3%,非首次添加组均为36.4%,两组有效率相比,差异有统计学意义(P<0.05)。局灶性发作(FOS)组临床及ESES改善有效率均为76.9%,局灶性继发双侧强直阵挛发作(FBTCS)组临床有效率为54.5%、ESES改善有效率为45.5%,全面性发作(GTCS)组临床及ESES改善有效率均为66.7%,三组临床及改善ESES有效率相比,差异均无统计学意义(P>0.05)。伴中央颞区棘波的自限性癫痫(SeLECTs)组临床及ESES改善有效率均为86.7%,其他癫痫综合征组均为50.0%,两组有效率相比,差异有统计学意义(P<0.05)。头颅MRI正常组临床及ESES改善有效率均为77.8%,头颅MRI异常组均为16.7%,两组有效率相比,差异有统计学意义(P<0.05)。所有患儿加药前及随访终点IQ值差异无统计学意义(P>0.05)。7例(20.0%)出现不良反应,其中2例(5.7%)因无法耐受而停药,5例(14.3%)减慢加药速度后症状消失,随访终点保留率为94.3%(33/35)。结论PER单药和添加治疗对控制发作和改善ESES均有效。不同发作形式(FOS、FBTCS、GTCS)患儿应用PER的疗效无明显差异。PER首次添加治疗控制发作及改善ESES的疗效优于非首次添加治疗。PER对SeLECTS或头颅MR
Objective To investigate the clinical efficacy of perampanel(PER)as monotherapy and as addition in the treatment of electrical status epilepticus(ESES)during sleep and the improvement in ESES,and to evaluate its safety and effect on cognitive function.Methods Totally 35 children with epilepsy complicated with ESES were selected and divided into groups according to medication mode,PER addition order,seizure form,type of epilepsy syndrome and normal or abnormal head MRI.The follow-up time points were 3 months,6 months and 12 months after medication,and the end point was 12 months after medication.The attack frequency,EEG discharge index and cognitive function of each follow-up point were compared before and after dosing in each group,adverse events at each follow-up point were recorded,and drug retention rate at the follow-up endpoint was calculated to assess the safety of PER.Results At the end of follow-up,the clinical and ESES improvement rates were 80.0%in the monotherapy group and 60.9%in the addition group.There was no significant difference between the two groups(P>0.05).The clinical and ESES improvement rates were 83.3%in the first addition group and 36.4%in the non-first addition group,and the difference between the two groups was statistically significant(P<0.05).The clinical and ESES improvement rates were 76.9%in the focal-onset seizure(FOS)group and 66.7%in the generalized tonic-clonic seizure(GTCS)group;the clinical rate was 54.5%and the improvement rate was 45.5%in the focal to bilateral tonic-clonic seizure(FBTCS)group;there was no significant difference in clinical or improved ESES efficiency among the three groups(P>0.05).The clinical and ESES improvement rates of the self-limited epilepsy with centrotemporal spikes(SeLECTS)group with central temporal spines was both 86.7%,and that of the other epileptic syndrome group was 50.0%,with statistical difference between the two groups(P<0.05).The clinical and ESES improvement rates were 77.8%in the normal brain MRI group,and 16.7%in the abnormal brain M
作者
闫婷
杜丽君
李晓媛
牛菲
贾利芳
王文徽
Yan Ting;Du Lijun;Li Xiaoyuan;Niu Fei;Jia Lifang;Wang Wenhui(Department of Pediatric Medicine,Shanxi Medical University,Taiyuan 030000,China;Department of Neurology,Shanxi Children's Hospital,Taiyuan 030000,China)
出处
《实用药物与临床》
CAS
2024年第9期668-672,共5页
Practical Pharmacy and Clinical Remedies
基金
山西省儿童医院院内课题(2021001)。
关键词
癫痫
癫痫性电持续状态
吡仑帕奈
儿童
Epilepsy
Electrical status epilepticus
Perampanel
Children
