苯巴比妥、依他普特和托帕麦克治疗新生儿癫痫发作的疗效:一项针对伊朗人群的双盲横断面研究。

IF 0.8 Q4 CLINICAL NEUROLOGY Iranian Journal of Child Neurology Pub Date : 2024-01-01 Epub Date: 2024-09-29 DOI:10.22037/IJCN.V18I4.43760
Shahram Sadeghvand, Leila Islamian Ghadim, Mir Hadi Mousavi, Gisou Erabi
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引用次数: 0

摘要

目的:癫痫发作是大脑电活动的变化。这些变化可引起明显或无症状的症状。苯巴比妥和苯妥英是治疗新生儿癫痫发作的已知药物,但使用其他药物的临床经验很少。本研究旨在评估与苯巴比妥相比,左乙拉西坦和托吡酯等其他药物治疗新生儿癫痫发作的疗效:在一项双盲临床试验中,纳入了两年内(2020-2022 年)因癫痫发作而入住转诊医院的所有新生儿。所有新生儿都接受了剂量为 10-40 毫克/千克/状态的苯巴比妥静脉注射治疗,以控制急性癫痫发作。之后,他们被分成三组,分别接受特定的治疗方案。第一组口服苯巴比妥 5 毫克/千克/天(维持治疗),第二组口服托吡酯 3-8 毫克/千克/天(维持治疗),第三组口服左乙拉西坦 10-40 毫克/千克/天(维持治疗)。通过访谈和医学脑电图测试对癫痫发作和潜在副作用进行了调查。数据采用卡方检验进行分析:研究了 60 名婴儿(每组 20 名新生儿)。在控制惊厥和大脑阵发性放电相关变化方面,苯巴比妥、依他普特和托吡酯没有显著差异:由于治疗时间长、副作用大,选择合适的药物治疗新生儿耐药性癫痫发作至关重要。本研究发现,苯巴比妥、左乙拉西坦和托吡酯对控制癫痫发作同样有效。这些药物还有助于消除儿童大脑阵发性异常。
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Efficacy of Phenobarbital, Italept, and Topamax in the Treatment of Neonatal Seizures:A Double-Blinded Cross-Sectional Study of the Iranian Population.

Objectives: Seizures are changes in the electrical activity of the brain. These changes can cause significant or otherwise asymptomatic symptoms. Phenobarbital and phenytoin are known drugs for treating neonatal seizures, but little clinical experience exists using other drugs. The present study aims to evaluate the efficacy of other drugs, such as Levetiracetam and Topiramate, compared to Phenobarbital in treating neonatal seizures.

Materials & methods: In a double-blind clinical trial, all neonates admitted to a referral hospital for two years (2020-2022) due to seizures were included. All of the neonates were treated with a dosage of 10-40mg/kg/state IV Phenobarbital to control the acute seizure. After that, they were divided into three groups with specific treatment programs. Groups were ordered with oral Phenobarbital 5mg/kg/day maintenance (first group), oral Topiramate 3-8mg/kg/day (second group), and 10-40mg/kg/day Levetiracetam (third group). Seizures and potential side effects were investigated through interviews and medical EEG tests. The data was analyzed using the Chi-square test.

Results: Sixty infants (20 neonates in each group) were studied. Phenobarbital, Italept, and Topiramate did not significantly differ in controlling convulsions and changes related to brain paroxysmal discharges.

Conclusion: Due to the long treatment duration and side effects, it is essential to choose the appropriate drug for treating treatment-resistant seizures of neonates. The present study found that Phenobarbital, Levetiracetam, and Topiramate are equally effective in controlling seizures. These medications can also help eliminate abnormalities in children's brain paroxysmal.

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