Clinical study of the effect of 5 kinds of antiepileptic drugs on the postictal state

IF 2.3 3区医学 Q2 BEHAVIORAL SCIENCES Epilepsy & Behavior Pub Date : 2024-07-15 DOI:10.1016/j.yebeh.2024.109897

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Abstract

Objective

To compare the effects of levetiracetam（LEV）, lamotrigine(LTG), oxcarbazepine(OXC), topiramate(TPM) and valproate (VPA) on postictal state (PIS).

Methods

A total of 187 epilepsy patients undergoing monotherapy were enrolled in a long-term follow-up study at the Affiliated Hospital of Yangzhou College. This included 30 patients on levetiracetam, 41 on valproate, 30 on oxcarbazepine, 28 on topiramate, and 31 on lamotrigine. A control group of 28 newly diagnosed or previously untreated epilepsy patients was also included. The Liverpool Seizure Severity Scale 2.0 (LSSS2.0) and the Seizure Severity Questionnaire (SSQ) were utilized to evaluate the patients’ condition, with comparison based on the results of the postictal status items. EEG during PIS termination was assessed using the Grand Total EEG score (GTE) as an objective tool to measure the impact of Antiseizure medications (ASMs) on the post-seizure state.

Results

The LSSS2.0 score indicated a statistically significant difference in post-seizure status score among the 5 groups (p < 0.05). The difference between the 5 groups and the control group was statistically significant (p < 0.05). Results of the SSQ demonstrated that all 5 drugs significantly reduced the post-seizure status score compared to the control group (p < 0.05). The GTE score revealed that, in the later stage of the seizure, the GTE score of the levetiracetam group, valproate group, oxcarbazepine group, and lamotrigine group significantly decreased compared to the control group (P < 0.05). There was no significant decrease in the GTE score in the topiramate group (P < 0.05).

Conclusion

Levetiracetam, lamotrigine, oxcarbazepine, topiramate, and valproate demonstrate favorable efficacy in ameliorating the severity of post-seizure condition. Further investigations are warranted to assess the potential of other widely employed anti-seizure medications in enhancing post-seizure status.

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5种抗癫痫药物对发作后状态影响的临床研究

目的比较左乙拉西坦（LEV）、拉莫三嗪（LTG）、奥卡西平（OXC）、托吡酯（TPM）和丙戊酸钠（VPA）对发作后状态（PIS）的影响。方法扬州学院附属医院对187例接受单药治疗的癫痫患者进行了长期随访研究。其中包括 30 名服用左乙拉西坦的患者、41 名服用丙戊酸钠的患者、30 名服用奥卡西平的患者、28 名服用托吡酯的患者和 31 名服用拉莫三嗪的患者。对照组包括 28 名新确诊或之前未接受过治疗的癫痫患者。采用利物浦癫痫发作严重程度量表 2.0 (LSSS2.0) 和癫痫发作严重程度问卷 (SSQ) 评估患者的病情，并根据发作后状态项目的结果进行比较。结果 LSSS2.0评分显示，5组患者发作后状态评分差异有统计学意义（P <0.05）。5 组与对照组之间的差异具有统计学意义（P < 0.05）。SSQ 的结果显示，与对照组相比，所有 5 种药物都能显著降低癫痫发作后的状态评分（p <0.05）。GTE 评分显示，在癫痫发作后期，左乙拉西坦组、丙戊酸钠组、奥卡西平组和拉莫三嗪组的 GTE 评分与对照组相比明显下降（P < 0.05）。结论左乙拉西坦、拉莫三嗪、奥卡西平、托吡酯和丙戊酸钠对改善癫痫发作后的严重程度具有良好疗效。有必要进行进一步研究，以评估其他广泛使用的抗癫痫药物在改善癫痫发作后状况方面的潜力。

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来源期刊

Epilepsy & Behavior 医学-行为科学

CiteScore

5.40

自引率

15.40%

发文量

385

审稿时长

43 days

期刊介绍： Epilepsy & Behavior is the fastest-growing international journal uniquely devoted to the rapid dissemination of the most current information available on the behavioral aspects of seizures and epilepsy. Epilepsy & Behavior presents original peer-reviewed articles based on laboratory and clinical research. Topics are drawn from a variety of fields, including clinical neurology, neurosurgery, neuropsychiatry, neuropsychology, neurophysiology, neuropharmacology, and neuroimaging. From September 2012 Epilepsy & Behavior stopped accepting Case Reports for publication in the journal. From this date authors who submit to Epilepsy & Behavior will be offered a transfer or asked to resubmit their Case Reports to its new sister journal, Epilepsy & Behavior Case Reports.