Control Study Of Oxcarbazepine And Valproate In Treatment Of Typical Benign Childhood Epilepsy With Centrotemporal Spikes

Objective:To compare the curative effect,epileptiform discharges index,cognitive improvement,and adverse drug reactions of oxcarbazepine or valproate monotherapy in children with typical benign childhood epilepsy with centro-temporal spikes(BECT),and in order to provide guidance for the clinical treatment of typical BECT.Methods:We collected inpatient or outpatient with typical BECT in department of neurology,Children's Hospital of Suzhou University.The 70 patients newly diagnosed typical BECT were randomly divided into oxcarbazepine group(34 cases)and valproate group(36 cases).Oxcarbazepine was starting from dose of 5-10mg/(kg·d),increased 5-10mg/(kg·d at intervals of one week,and a maintenance dose of 20-30mg/(kg·d).valproate was starting from dose of 5-10mg/(kg·d),the weekly increase 5-10mg/(kg·d),and a maintenance dose of 20-30mg/(kg·d).We followed for 2 years for observation clinical efficacy of oxcarbazepine or valproate monotherapy.Meanwhile,by long-range dynamic or video electroencephalogram,we computed EEG epileptiform discharges index in order to evaluate EEG improvement,and measured IQ of Wechsler Intelligence Scale for Children in order to evaluate cognitive function improvement,and finally,adverse drug reactions were compared between the oxcarbazepine group and valproate group.Results:(1)In this study,total effective rate of oxcarbazepine and valproate was respectively 94.11%(32/34),91.66%(33/36)(?2 = 0.158,P = 0.528)after one year of follow-up treatment.91.17%(31/34),83.33%(30/36)(?2 = 0.960,P = 0.479)after 2 years of treatment.There was no significant difference between oxcarbazepine group and valproate group.(2)After 1 year of treatment of 70 cases,EEG improvement rate of oxcarbazepine or valproate monotherapy were respectively 64.70%(22/34),63.88%(23/36)(?2 = 0.0051,P = 1.000).After 2 years of treatment of 70 cases,EEG improvement rate was respectively 76.47%(26/34),69.44%(25/36)(?2 = 0.4365,P = 0.5955).EEG situation of children with typical BECT was able to improve by oxcarbazepine or valproate monotherapy,but there was no significant difference between the oxcarbazepine group and valproate group.(3)After 2 years of treatment of 70 cases,there was significant improvement of cognitive function than prior treatment in oxcarbazepine group or valproate group,but oxcarbazepine group was significant improvement of cognitive function than valproate group.(4)After 2 years of treatment of 70 cases,there were 5 cases(14.70%)of adverse reaction in oxcarbazepine groupe,11 cases(30.55%)of adverse reactions in valproate group.The incidence of adverse reactions in oxcarbazepine group was significantly lower than the incidence of adverse reactions in valproate group.Conclusion:(1)By oxcarbazepine or valproate treatment for typical BECT,Clinical symptoms of children with typical BECT can effectively relieve in oxcarbazepine group and valproate group,but there was not significant difference in curative effect between oxcarbazepine group and valproate group.(2)EEG situation of children with typical BECT was able to improve by oxcarbazepine or valproate monotherapy,but there was no significant difference between oxcarbazepine group and valproate group.In addition,oxcarbazepine group was significant improvement of cognitive function than valproate group.(3)In the incidence of adverse reactions,oxcarbazepine group was significantly less than valproate group.The antiepileptic effect of oxcarbazepine in children with typical BECT was satisfied and adverse reaction was light and mostly transient.The drug retention rate is high and should be used extently.