Comparative Study In Treatment Of Benign Childhood Epilepsy With Centrotemporal Spikes By Levetiracetam And Oxcarbazepine

Background and objective: Benign epilepsy of childhood with centro- temporal spikes by Levetiracetam and Oxcarbazepine (BECT) is the most common epileptic syndrome in childhood, and its chief clinical manifestation was partial seizures. Currently, Oxcarbazepine is the first-line drug for treating partial epilepsy, having positive curative effects on treating BECT. This experiment is an open and parallel research designed to determine the effectiveness, tolerance and cognitive influence of single-agent Levetiracetam in the treatment of the first-episode BECT children patients by comparing with Oxcarbazepine.Methods:We choose 53 children patients from those seeking medical services in our hospital, who have clinical and EEG manifestations conforming to BECT, and require medications and approval from their guardians; in the physical examination, their nervous systems are free from positive signs and obvious mental retardation; there is no obvious abnormality in CT or MRI, without going through anti-epilepsy treatment; LEV therapy is not applied to children patients with chronic progressive diseases; additionally, 51 children patients meeting the above-mentioned conditions, with qualified age and course of disease and whose economic position and educated level of their parents were basically matched, are treated with OXC therapy. By taking the monthly average seizure times of three months prior to the experiment as the baseline seizure level, we have made phone or clinical return visits for 2-4 weeks, recording times of clinical seizures and reverse reactions. Evaluations on cognitive functions were conducted in three months before and after taking medicine and in six and twelve months after medicine-taking (Wechslet preschool and primary scale of intelligence are applied to patient children at the age of 4-6, and Wechsler intelligence scale for children applied to those at the age of 6-16), and with examinations of EEG, BEAM, blood and urine routine, liver and kidney functions and ECG made.Results: (1) Comparison of curative effects: after taking medicine for three months, six months or one year, effective rates of LEV group and OXC group are 96% and95.7%, 97.9% and 95.4%, and 97.7% and 97.6% respectively, and non-seizure rates are 84% and 72.3%, 85.1% and 72.1%, and 86.1% and 73.2% respectively. There is no difference between effectiveness of return visiting time among different groups. (2) Comparison of EEG. Rates for above 50% discharge reduction of LEV group during three return visits after treatment (all disappearance included ) are 14%, 23.4% and 41.9% respectively; those for OXC group are 6.4%, 11.6% and 19.5% respectively. The complete disappearance rates of epileptiform discharge for LEV group are 0%, 17% and 23.3% respectively, that for OXC group are 0%, 2.3% and 7.3% respectively. The differences between EEG changes of two groups are of no statistical significance. The comparative cost differences between complete disappearance rates of epileptiform discharge of LEV group after taking medicine for one year are of statistical significance. The frequency for frequencyαof EEG of OXC group after receiving the treatment is reduced. There are no obvious changes in various frequency of EEG of LEV group before and after being received. (3) Comparison of cognitive function: There are no obvious changes in comparing cognitive functions of children from LEV group and OXC group based on the baseline level. Self- control comparison between two groups of children before and after taking shows that scores in various subtests intend to increase, but changes of OXC group before and after receiving treatment are of no statistical significance, and comparison of improvement range of test scores in words and digit span of LEV group before and after receiving treatment is of statistical significance. (4) Adverse reaction and retention rate: There are a total of 11 cases suffering adverse reaction in LEV (20.7%), and 13 cases of adverse reaction in OXC group (25.5%). Retention rates for three return visits of LEV group are 94.3%, 88.7% and 81.1% respectively, while those of OXC group are 92.2%, 84.3% and 80.4% respectively. Retentions rates of LEV group are slightly higher that those of OXC group, but comparison between two groups after the ending of 12 months of follow-up visits is of no statistical significance.Conclusions:Curative effect of LEV on first-episode BECT children patients is similar to that of OXC, which can better reduce the abnormal discharge of epileptic children patents, have little adverse reaction and without adverse influence on cognition of BECT children patients.