| Objective:To compare the effects of AEDs on cognitive function before and after treatment in children with epilepsy, and analysis the efficacy and adverse reactions. Providing necessary help and guidance on the choice of drugs for pediatricians in children with epilepsy.Methods: 78 children patients were selected for this follow-up survey,who were newly diagnosed with epilepsy in outpatient between 2015 and 2016 March,were randomly divided into 2 groups: the Valproic Acid(VPA) group(n=39) and the Levetiracetam(LEV) group(n=39). The cognitive function of all the patients in these two groups under 4 years old were evaluated by the Gesell developmental scales( GDS),while over 4 years old and under 18 years old were evaluated by the Wechsler Intelligence Scale for Children(WISC) and Electroencephalogram(EEG) before treatment and after six months administration of VAP /LEV.The SPSS version 19.0 was used for statistical analysis. Statistical significance was accepted at P<0.05.The X,2-test were used to determine the associations in categorical data.The T-test were used to determine the associations in measurement data.Results: 1.VPA group and LEV group after treatment, VPA controlled Seizure(SE) in 89.74.%( 35), LEV controlled Seizure(SE) in 92.31%(36). There was also no significant difference in the two groups(P = 0.096) after 3 months 2; VPA improved EEG in 51.28%(20), improved EEG in 43.59%(17),There was also no significant difference in the two groups(P0.16,>0.05) 3, After administration,VPA group in 3 cases(7.69%), 2 cases in group LEV(5.1%), side effects are mainly :headache, fatigue, dizziness irritability,loss of appetite,et al. The side effect is mild.With the prolonged use of the AEDs, the side effects of symptoms gradually reduced or disappeared. There was also no significant difference in the two groups(P>0.05). 4 Comparison the Neuropsychological Index(NI) before administration of VPA group and LEV group: both the 0-4 age group, or the 4-18 age group, there were no significant differences in the total IQ, ability, physical ability, kinetism(gross motor and fine motor) in the two groups(P>0.05). It showed that the two groups had better homogeneity in intellectual development.5 The NI of VPA group and LEV group: After administration, whether the 0-4 age group, or the 4-18 age group, there were no significant differences in the total IQ, ability, physical ability, kinetism(gross and fine motor), language ability, operation ability in the two groups(P>0.05). 6. 78 cases of children(both with VPA or Lev) divided into two groups by age : 6.1 The NI of 0-4 years old group(40 cases, 51.28%). Throught self comparison: total IQ, physical ability, fine motor and language ability were improved, and there were significant differences(P < 0.05). 6.2 4-18 years group(38 cases, 48.72%) Throught self comparison:total IQ, operation ability, language ability had no obvious improvement, there were no significant differences(P > 0.05).7.VPA group: 7.1 The NI of 0-4 years old group:The patients’ physical ability improved, there was significant difference between before treatment and after administration(P < 0.05). There were no significant difference in the athletic ability and language ability(P > 0.05). 7.2 The NI of 4-18 years old group: There were no significant difference in the total IQ, language ability and operation ability(P>0.05). 8.LEV group: 8.1 The NI of 0-4 years old group : There were significant differences in the total IQ, gross motor, fine motor, language ability between before treatment and after administration(P<0.05).But there were no significant differences in cases of ability, physical ability between before treatment and after administration(P>0.05). 8.2 The NI of 4-18 age group :there were significant differences between before treatment and after administration(P<0.05), but there was no significant difference between before treatment and after administration in the language ability(P>0.05). 9 The gender(43 male, 55.13%, 35 female, 44.87%) before and after the administration of NI: both 0-4 years old group, or 4-18 years old group, there were no significant differences in the total IQ, cases ability, capacity, exercise capacity(gross and fine motor), language ability and operation ability.(P > 0.05).Conclusion: VPA and LEV as Two kinds of clinical commonly used broad-spectrum antiepileptic drugs,through a large number of animal experiments and clinical application of various types of epilepsy have proved to have better control effect. The opinions of other experts are confirmed by this study. In a relatively short follow-up, observation time,it was found that The control rate and the improvement rate of EEG of two kinds of drugs in different age groups were very similar. But there are some differences among the different age groups of children with epilepsy and cognitive function, intelligence development.After administrateration of VPA/LEV,the SE of the patients were effectively controlled, VPA and LEV can improve EEG. And the adverse reactions were mild after administrateration. VPA and LEV can improve the cognitive function of the children with epilepsy Especially in children with small age group.The specific performances are as follows:1、VPA and LEV in the different age groups of children with short-term control rate were higher(about 90%).The improvement rate of EEG was about 45%. The results show that VPA and LEV have satisfactory effects on the control of children’s SE and the improvement of EEG. It means VPA and LEV can widely used for children’s SE.2、Children regardless of the use of VPA, or LEV,The adverse reactions were mild and rare, all of which could be tolerated. It’s safe that VPA and LEV in a certain dose range for children Patients.3、The study found that VPA or LEV almost has no adverse effects on the cognitive function. The NI score of many children patients had improved,especially in low age group. Indicated that VPA and LEV not only suitable for elder children patients,but also suitable for elder children the little baby.4、Lev and VPA almost had no adverse effects on children’s cognitive function. There is even some improvement.This is related to their anti-epilepsy mechanism and molecular structure. In particular, LEV, which is a mirror isomer of pyrrolidone derivative. It can promote the synthesis of ATP in the brain, which has the function of improving the brain function.5、The results of this study are in good agreement with the domestic and foreign experts’ research in some aspects. Because of the small number of cases and The short time of follow-uping,even some case with obvious brain structural abnormalities were deleted, so the conclusion is only for reference. And more extensive, in-depth, multi center, large sample of clinical research is worth looking forward to and carry out. |
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