Clinical efficacies of lacoxamide and perampanel as add-on therapy for refractory focal epilepsy in children and their influences on patients'serum S100β and NSE levels
Objective To investigate clinical efficacies of lacoxamide and perampanel as add-on therapy on refractory local epilepsy in children and their influences on serum S-100β protein(S100β)and neuron-specific enolase(NSE)levels.Methods A total of 122 children with refractory local epilepsy who admitted to our hospital and had poor therapeutic effects in initial single antiepileptic drug treatment from December 2019 to December 2022 were selected as study subjects,In random number table method,the children were divided into two groups:lacoxamide group(n=61,the children received lacoxamide add-on therapy)and perampanel group(n=61,the children received perampanel add-on therapy).The therapeutic effects,intelligence quotient(IQ),cognitive function(CF),serum S100β and NSE levels before and after treatment and adverse reactions during treatment were compared between the two groups.Results There were no significant differences in total response rates at 1 month,3 months and 6 months of treatment between the two groups(all P＞0.05).After treatment,the scores in performance intelligence quotient(PIQ)in Chinese-Wechsler intelligence scale of children(C-WISC)of the children in the lacoxamide group were higher than those before treatment(Z=2.775,P＜0.05),and the scores were also higher than those in the perampanel group(Z=2.432,P＜0.05).And the scores in short-term memory span of the children in the lacoxamide group after treatment were higher than those before treatment(Z=2.849,P＜0.05).While in the perampanel group,after treatment,the scores in attention allocation test and short-term memory span of the children were lower than those before treatment(Z=2.522 and 2.475 respectively,both P＜0.05).After treatment,the scores in attention allocation test and short-term memory span of the children in the lacoxamide group were higher than those in the perampanel group(Z=3.065 and 4.035 respectively,both P＜0.05).After treatment,the serum S100β and NSE levels of the children in the two groups were higher than before treatment(in the lacoxamide group:t=14.575 and 14.096 respectively;in the perampanel group:t=10.747 and 10.841 respectively,all P＜0.05),and there were no statistical significant differences between the two groups before and after treatment(all P＞0.05).The incidence of irritability as an adverse reaction of the children in the perampanel group was higher than that in the lacoxamide group(P＜0.05).Conclusion In treatment of refractory local epilepsy in children,both lacoxamide and perampanel can effectively control onset of seizures,reduce the serum levels of S100β and NSE of the children,and they exert few effects on intelligence of the children,in addition,perampanel has certain negative effects on cognitive function and mental state of the children.
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