The Journal of Practical Medicine >

2026 , Vol. 42 >Issue 13: 2438 - 2443

DOI: https://doi.org/10.3969/j.issn.1006-5725.2026.13.020

Treatise：Mechanism and Practice

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

  • Xiaoping JIANG ,
  • Ting WU ,
  • Wenting ZHANG ,
  • Lina LIAO ,
  • Jianrong LIU
Expand
  • Department of Neurology，Changzhou Children's Hospital Affiliated to Nantong University，Changzhou 213000，Jiangsu，China

Received date: 2026-04-08

  Online published: 2026-07-14

Fold

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

Cite this article

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 . DOI: 10.3969/j.issn.1006-5725.2026.13.020

References

[1] WANG X， ZHANG Y， SUN R， et al. Risk factors of electrical status epilepticus during sleep in children with benign childhood epilepsy with centro-temporal spikes： Electrical Status Epilepticus During Sleep in Children with Benign［J］. Pak J Med Sci， 2024， 40（4）： 612-616. doi：10.12669/pjms.40.4.7674 .
[2] DIDOMENICO L， GARRITY L C， POISSON K E， et al. Enteral ketamine for status epilepticus in children with epilepsy［J］. Pediatr Neurol， 2024， 158： 41-48. doi：10.1016/j.pediatrneurol.2024. 05.006 .
[3] JELLINEK E R， DUDA T A， FEIN R H. The RUBI parent training for disruptive behavior in a child with electrical status epilepticus in sleep （ESES）： A case report［J］. J Clin Psychol Med Settings， 2023， 30（4）： 770-779. doi：10.1007/s10880-023-09949-1 .
[4] KASATKINA L A， GUMENYUK V P， LISAKOVSKA O O， et al. Targeting hippocampal amyloidogenesis with SV2A protein modulator levetiracetam［J］. Biochem Pharmacol， 2022， 197： 114927. doi：10.1016/j.bcp.2022.114927 .
[5] HUANG Y T， HUANG T H， CHEN Y S， et al. Role of α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors and the antagonist perampanel in geriatric epilepsy and status epilepticus［J］. Arch Gerontol Geriatr， 2025， 128： 105605. doi：10.1016/j.archger.2024.105605 .
[6] KANSAL B， ANAND A， GARG D， et al. Applicability of the International League Against Epilepsy （ILAE） 2022 diagnostic criteria for epilepsy syndromes in children： A retrospective review of 1550 children with epilepsy［J］. Seizure Eur J Epilepsy， 2024， 117： 288-292. doi：10.1016/j.seizure.2024.03.016 .
[7] 孙晴晴， 张亚男， 汤琪， 等. 癫痫共病睡眠障碍治疗中国专家共识解读与评价［J］. 中风与神经疾病杂志， 2020， 37（11）： 1039-1042. doi：10.19845/j.cnki.zfysjjbzz.2020.0515 .
[8] NA S D， BURNS T G. Wechsler intelligence scale for children-V： Test review［J］. Appl Neuropsychol Child， 2016， 5（2）： 156-160. doi：10.1080/21622965.2015.1015337 .
[9] 刘安红， 张静， 李书香， 等. ALG13突变相关糖基化障碍型癫痫的研究进展［J］. 实用医学杂志， 2025， 41（8）： 1091-1096. doi：10.3969/j.issn.1006-5725.2025.08.001 .
[10] RUBBOLI G， GARDELLA E， CANTALUPO G， et al. Encephalopathy related to status epilepticus during slow sleep （ESES）. Pathophysiological insights and nosological considerations［J］. Epilepsy Behav， 2023， 140： 109105. doi：10.1016/j.yebeh. 2023.109105 .
[11] LOLAM V， ROY A. Developmental mechanisms underlying pediatric epilepsy［J］. Front Neurol， 2025， 16： 1586947. doi：10.3389/ fneur.2025.1586947 .
[12] MEADOR K J， COHEN M J， LORING D W， et al. Two-year-old cognitive outcomes in children of pregnant women with epilepsy in the maternal outcomes and neurodevelopmental effects of antiepileptic drugs study［J］. JAMA Neurol， 2021， 78（8）： 927. doi：10.1001/jamaneurol.2021.1583 .
[13] MOON J U， HAN J Y. Comparative efficacy of levetiracetam for epilepsy in school-aged children with intellectual disability and normal intelligence［J］. Brain Sci， 2021， 11（11）： 1452. doi：10.3390/brainsci11111452 .
[14] LI D， HUANG S， WANG X， et al. Efficacy and adverse reactions of perampanel in the treatment of epilepsy in children［J］. Front Neurol， 2022， 13： 924057. doi：10.3389/fneur.2022. 924057 .
[15] AVLONITI M， EVANGELIDOU M， GOMINI M， et al. IKKβ deletion from CNS macrophages increases neuronal excitability and accelerates the onset of EAE， while from peripheral macrophages reduces disease severity［J］. J Neuroinflammation， 2024， 21（1）： 34. doi：10.1186/s12974-024-03023-9 .
[16] HOTZ A L， JAMALI A， RIESER N N， et al. Loss of glutamate transportere aat2aleads to aberrant neuronal excitability， recurrent epileptic seizures， and basal hypoactivity［J］. Glia， 2022， 70（1）： 196-214. doi：10.1002/glia.24106 .
[17] BELLINGACCI L， TALLARICO M， MANCINI A， et al. Non-competitive AMPA glutamate receptors antagonism by perampanel as a strategy to counteract hippocampal hyper-excitability and cognitive deficits in cerebral amyloidosis［J］. Neuropharmacology， 2023， 225： 109373. doi：10.1016/j.neuropharm.2022. 109373 .
[18] PERVERSI F， COSTA C， LABATE A， et al. The broad-spectrum activity of perampanel： State of the art and future perspective of AMPA antagonism beyond epilepsy［J］. Front Neurol， 2023， 14： 1182304. doi：10.3389/fneur.2023.1182304 .
[19] 雷丹荣， 王佳娟， 代海兵， 等. 吡仑帕奈对癫痫大鼠CC趋化因子受体5表达及海马神经元损伤的影响［J］. 中华老年心脑血管病杂志， 2025， 27（7）： 946-951. doi：10.3969/j.issn.1009-0126.2025.07.024 .
[20] KLINZING J G， TASHIRO L， RUF S， et al. Auditory stimulation during sleep suppresses spike activity in benign epilepsy with centrotemporal spikes［J］. Cell Rep Med， 2021， 2（11）： 100432. doi：10.1016/j.xcrm.2021.100432 .
[21] BALARAM N， BALACHANDRAN S， GAFOOR A V， et al. Clinical and electrical evolution of “pseudo” spike-wave activation in sleep EEG patterns in self-limited childhood epilepsies［J］. Ann Indian Acad Neurol， 2025， 28（3）： 426-431. doi：10.4103/aian.aian_899_24 .
[22] ISLA A G， BALLEZA-TAPIA H， CHU F， et al. Low dose of levetiracetam counteracts amyloid β-induced alterations of hippocampal gamma oscillations by restoring fast-spiking interneuron activity［J］. Exp Neurol， 2023， 369： 114545. doi：10.1016/j.expneurol.2023.114545 .
[23] 罗翠蜜， 陈子蓉， 黄东莹， 等. 钠离子通道阻滞剂药物治疗颞叶癫痫相关的脑功能复杂网络的变化［J］. 实用医学杂志， 2025， 41（2）： 250-257. doi：10.3969/j.issn.1006-5725.2025. 02.015 .
[24] 王星辰， 刘瑞寒， 肖翔宇， 等. TRPM2离子通道在颞叶癫痫相关神经炎症中的作用研究［J］. 新医学， 2024， 55（3）： 214-221. doi：10.3969/j.issn.0253-9802.2024.03.012 .
[25] LIU P， ZHU Z， WU H. The safety of perampanel in different disorders and doses： A meta-analysis［J］. Seizure Eur J Epilepsy， 2023， 106： 22-28. doi：10.1016/j.seizure.2023.01.013 .
[26] DIZA-FELIZ L， FELIZ-FELIZ C， DEL VAL J， et al. Perampanel： Medical Alternative for Essential Tremor［J］. Clin Neuropharmacol， 2023， 46（2）： 51-54. doi：10.1097/WNF. 0000000000000541 .
Options
Outlines

/

〈 〉