吡仑帕奈联合左乙拉西坦治疗儿童自限性癫痫伴中央颞区棘波合并睡眠中癫痫电持续状态的疗效与脑电频谱分析

doi:10.3969/j.issn.1006-5725.2026.13.020

Abstract

Abstract:

Objective To evaluate the efficacy and electroencephalographic （EEG） spectral changes of perampanel combined with levetiracetam in children with Self-Limited Epilepsy with Centrotemporal Spikes （SeLECTS） complicated by Electrical Status Epilepticus during Sleep （ESES）. Methods A total of 86 children with SeLECTS complicated by ESES， admitted to our hospital between June 2023 and June 2025， were enrolled. Participants were randomly assigned to a control group （n = 43） or an observation group （n = 43） using a random number table. The control group received oral levetiracetam monotherapy， while the observation group received perampanel added to the levetiracetam regimen. Both groups underwent a 6-month treatment course. Seizure frequency， seizure duration， and EEG spike-wave discharge index were recorded before and after treatment. Serum neuron-specific enolase （NSE） levels and EEG spectral parameters （relative power of delta， theta， alpha， and beta bands） were compared. Cognitive function was assessed using the Wechsler Intelligence Scale for Children （WISC）， evaluating performance IQ， verbal IQ， and full-scale IQ. Adverse events were systematically documented. Results Following treatment， the observation group demonstrated significantly lower seizure frequency， shorter seizure duration， and a reduced spike-wave discharge index compared with the control group （all P 0.05）. EEG spectral analysis revealed higher relative power of theta and delta waves， alongside lower beta and alpha wave power， in the observation group than in the control group （P 0.05）. The observation group also exhibited significantly lower NSE levels and higher WISC scores than the control group （P 0.05）. No significant difference was observed in the incidence of adverse events between the two groups （χ2 = 1.042， P = 0.307）. Conclusion The combination of perampanel and levetiracetam effectively reduces seizure burden， ameliorates EEG abnormalities， mitigates neuronal injury， and improves cognitive function in children with SeLECTS complicated by ESES， while maintaining a favorable safety profile comparable to levetiracetam monotherapy.

Key words: self-limited epilepsy with centrotemporal spikes, electrical status epilepticus during sleep, perampanel, levetiracetam

CLC Number:

R971.6

Xiaoping JIANG,Ting WU,Wenting ZHANG,Lina LIAO,Jianrong LIU. Efficacy and EEG spectral analysis of perampanel combined with levetiracetam in children with SeLECTS complicated by electrical status epilepticus during sleep[J]. The Journal of Practical Medicine, 2026, 42(13): 2438-2443.

Figures/Tables 5

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References 26

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组别	例数	性别/例		年龄/岁	体质量/kg	病程/年	并发症/［例（%）］
组别	例数	男	女	年龄/岁	体质量/kg	病程/年	学习困难	行为障碍
对照组	43	27	16	7.46 ± 1.56	31.59 ± 4.48	3.16 ± 0.76	9（20.9）	7（16.3）
观察组	43	23	20	7.30 ± 1.34	31.22 ± 4.24	3.27 ± 0.79	6（14.0）	8（18.6）
t/χ²值		0.764		0.598	0.372	0.843	0.727	0.081
P值		0.382		0.552	0.711	0.402	0.394	0.776

组别	例数	发作频率/（次/月）		持续时间/（min/次）		放电指数/%
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	43	3.63 ± 0.75	2.14 ± 0.37	4.66 ± 0.70	2.22 ± 0.34	88.84 ± 8.58	69.85 ± 7.26
观察组	43	3.57 ± 0.72	1.00 ± 0.23	4.54 ± 0.62	1.46 ± 0.24	89.13 ± 9.03	60.47 ± 6.22
t值		0.381	17.159	0.842	11.975	0.153	6.434
P值		0.704	0.05	0.402	0.05	0.879	0.05

组别	例数	NSE
组别	例数	治疗前	治疗后
对照组	43	22.45 ± 4.54	16.31 ± 2.91
观察组	43	22.18 ± 4.42	12.02 ± 2.24
t值		0.279	7.660
P值		0.781	0.05

组别	例数	θ波		β波		δ波		α波
组别	例数	干预前	干预后	干预前	干预后	干预前	干预后	干预前	干预后
对照组	43	5.04 ± 0.65	6.09 ± 0.69	23.56 ± 3.12	18.11 ± 2.55	2.21 ± 0.34	2.62 ± 0.38	10.82 ± 1.76	10.07 ± 1.06
观察组	43	5.02 ± 0.61	6.91 ± 0.71	23.84 ± 3.27	15.89 ± 2.19	2.26 ± 0.39	3.08 ± 0.41	10.59 ± 1.51	9.10 ± 0.85
t值		0.147	5.431	0.406	4.331	0.634	5.396	0.650	4.630
P值		0.883	0.05	0.686	0.05	0.528	0.05	0.517	0.05

组别	例数	操作智商		语言智商		全量表智商
组别	例数	治疗前	治疗后	治疗前	治疗后	治疗前	治疗后
对照组	43	91.81 ± 5.32	99.97 ± 7.41	90.23 ± 5.41	99.01 ± 6.74	91.51 ± 5.62	101.13 ± 6.95
观察组	43	92.25 ± 5.49	105.24 ± 8.54	90.75 ± 5.68	109.25 ± 7.24	91.26 ± 5.41	107.60 ± 7.26
t值		0.283	3.056	0.589	6.788	0.193	4.689
P值		0.778	0.050	0.543	0.050	0.847	0.050

Efficacy and EEG spectral analysis of perampanel combined with levetiracetam in children with SeLECTS complicated by electrical status epilepticus during sleep

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