The Clinical Observation Of Levetiracetam On Diagnosed Adult Patients With Epilepsy

ObjectiveTo observe the effect of levetiracetam on the treatment of adult epilepsy and the effect of mental state and cognitive function.MethodsWe collected the 70 cases of epileptic patients at the out-patient clinic and hospitalization of Yan'an University Affiliated Hospital branch institute during November2016 to September 2017.They were randomly divided into two groups.One group was the experimental group taking Levetiracetam tablets,named LEV group.And the other was control group treated with sodium valproate sustained-release tablets,named VPA group.The HAMA-14 and HAMD-24 scores were used to evaluate the mental state of the patients,and the MMSE score was used to evaluate the cognitive function of the patients.We observed and recorded the epileptic seizures and adverse reactions.The data were analyzed by SPSS20.0 statistical software.According to the data type,the measurement data were expressed by?x±s,and t test was used.Counting data was expressed by percentage.Chi square test was used for comparison between groups.All data were tested by bilateral test,and p<0.05 was statistically significant.Result1.The experimental group contained 35 patients,there were 21 men,and 14 women;their age were from 16 to 80 years old,mean age(38.97±21.10)years old;the duration of epilepsy were from 5 months to 50 years,the average duration(6.84±9.84)years;seizure frequency of epileptic patients 0.5-20 times per month,the average seizure frequency of(3.24±5.27)times per month;according to the type of epileptic seizures,12patients with partial seizures,the seizure in 23 cases;the causes of the disease in 18patients were clear,but the others with a poor cause.The control group also had 35 cases,24 men,11 women;their age were from 18 to 84 years old,average age(49.80±17.26)years old;the duration of epilepsy were from 3 months to 48 years,the average duration(8.85±11.98)years;seizure frequency of epileptic patients 0.5-30 times per month,the average seizure frequency of(3.12±5.67)times per month;the type of epileptic seizures,15 patients with partial seizures,generalized seizures in 20 cases;the causes of the disease in 15 patients were clear,but the others with a poor cause.There was no significant difference in gender,age,education level,body weight,duration of disease,symptom difference,HAMD-24 score,HAMA-14 score and MMSE score between the two groups(p>0.05)before treatment.2.After 6 months of treatment,observingd the effect of two groups of drugs:in the group of LEV,the situation of seizure of the 9(25.71%)patients were horoughly controlled,16(45.71%)patients were excellence effective,6(17.14%)patients were effective,and 4(11.43%)patients were invalid,so the total efficiency rate was 88.6%(31/35).In the group of VPA,the seizures of the 12(34.29%)patients were horoughly controlled,15(42.86%)patients were excellence effective,3(8.57%)were effective,and 5(14.29%)were invalid,so the total efficiency rate is 85.7%(30/35).There was no significant difference in total effective rate and effect grade between LEV and VPA(P>0.05).We further compared the efficacy of two groups of antiepileptic drugs according to the classification of epilepsy.There was no significant difference in the efficacy of focal seizures and generalized seizures in all groups(p>0.05),and got the same results between the two groups(p>0.05).So VPA and LEV are both effective in the treatment of epilepsy.3.In the LEV group,there was no significant difference in the HAMD-24 scores(p>0.05).In the VPA group,compared with pre-treatment,the HAMD-24 scores at the fifth and sixth month descented obviously(p<0.05).Compared two groups,there was no significant difference before and after the treatment(p>0.05).4.The HAMA-14 score of LEV group statistically increased at the first and second month(p<0.05),and there was a statistically significant difference compared wih the same terms of the VPA group.There was no significant difference in the HAMA-14 score between the VPA group before and during the treatment.5.After 6 months of treatment,the post-treatment MMSE score was higher than the prior-treatment in group LEV(p<0.05)?The increase in the"force"and"memory"scores suggests that LEV may improve the cognitive function of the epileptic patients.The MMSE score of group VPA was reduced before and after treatment,but there was no significant difference(p>0.05),suggesting that VPA had no significant effect on the cognitive function of the patients.Compared VPA and LEV,there was no significant difference in MMSE score(p>0.05),suggesting that the improvement of cognitive function between LVE and VPA was not significant.6.The adverse reactions:there was 9(25.7%)patients with adverse reactions during the treatment in the LEV group,and 17(48.6%)patients in the VPA group?For example,5 cases(14.3%)had tired,4 cases(11.4%)had irritability,dizziness,drowsiness and abdominal discomfort both in 1 case(2.9%)in the LEV group.In the VPA group,sleepiness occurred in 6 cases(17.1%),3 cases(8.6%)unresponsive,upset,irritability,headache,and weakness in 2 cases(5.7%).A case(2.9%)got weightier(increased 4kg).In a case(5.7%),the patient's liver function ALT increased in the third month after taking VPA,continuous monitoring of ALT 58-76U/L.The adverse reaction of group LVE was less than that of group VPA(?~2=0.043,p=0.049).Conclusion:1.The study showed that both levetiracetam and valproate have good curative effect.2.The patients had a short-term anxiety in the early stage of the levetiracetam group.3.Levetiracetam may improve the cognitive function of the patients4.Compared with sodium valproate,levetiracetam had less adverse reaction and better security.5.Sodium valproate may have an effect on improving depression.