Zhongguo quanke yixue (Aug 2023)
Effect of Sodium Valproate, Oxcarbazepine and Levetiracetam on the Development of Different Functional Areas in Children with Epilepsy by Griffiths Development Scales-Chinese Edition
Abstract
Background Epilepsy is a chronic episodic brain disorder with a high incidence and can seriously affect the quality of life of the patients. Therefore, timely treatment to control seizures is particularly important. Numerous studies have shown the effect of antiepileptic drugs on cognition, but there are few studies on the effects of different functional areas in children. Objective To explore the effects of sodium valproate (VPA) , oxcarbazepine (OXC) and levetiracetam (LEV) on the development of different functional areas in children with focal epilepsy by Griffiths Development Scales-Chinese Edition (GDS-C) . Methods A total of 83 children with focal epilepsy who attended in outpatient and ward of the Department of Pediatric Neurology of the Third Affiliated Hospital of Zhengzhou University for the first time from January 2021 to April 2022 were selected, and randomly divided into VPA group (n=27) , OXC group (n=28) and LEV group (n=28) according to the random number table method, 30 healthy children who were examined during the same period were selected as the control group. The changes of EEG interictal epileptiform activity (IEA) before and after 6 months of treatment were recorded and the clinical effect was evaluated according to seizure frequency, the GDS-C was used to evaluate the development quotient of each functional area in the children. Results The total clinical effective rates of VPA group, OXC group and LEV group were 92.6%, 89.3% and 92.9%, with no significant difference among the three groups (χ2=0.418, P=1.000) . The total EEG IEA effective rate of the VPA group, OXC group and LEV group were 88.9%, 57.1% and 89.3%, with significant differences among the three groups (χ2=11.152, P=0.004) ; the total effective rate of EEG IEA in OXC group was lower than that in VPA group and LEV group (P<0.05) . Before treatment, there were statistically significant differences in the the development quotient of each dimension among four groups (P<0.05) ; the development quotient of each dimension in three groups were lower than that in the control group (P<0.05) . After treatment, there were significant differences in the the development quotients of hand-eye coordination and performance dimensions among three groups (P<0.05) ; the development quotients of sports and personal-social dimensions in LEV group were higher than VPA group (P<0.05) , the development quotients of personal-social, hand-eye coordination and performance dimensions in LEV group were higher than OXC group (P<0.05) . Compared to the pre-treatment period, the development quotients of personal-social and practical reasoning dimensions significantly decreased in VPA group (P<0.05) , the development quotients of personal-social, language, hand-eye coordination, performance and practical reasoning dimensions significantly increased (P<0.05) . Conclusion VPA, OXC and LEV are all effective in the treatment of focal epilepsy in children, and all three have quivalent efficacy; In terms of improving EEG IEA, OXC is inferior to VPA and LEV; VPA may have a negative effect on personal-social and practical reasoning dimensions, OXC has little effect, and LEV may have improvement on personal-social, language, hand-eye coordination, performance, practical reasoning dimensions.
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