Observation of Therapeutic Efficacy of Oxcarbazepine Combined with Levetiracetam in the Treatment of Cognitive Dysfunction in Adult Patients with Temporal Lobe Epilepsy / 中国药房

ABSTRACT

OBJECTIVE：To observe therapuetic effica cy of oxcarbazepine combined with levetiracetam in the treatment of cognitive dysfunction in adult patients with temporal lobe epilepsy. METHODS ：According to inclusion and exclusion criteria ，83 adult patients with temporal lobe epilepsy were collected from neurology department of the First Affiliated Hospital of Kunming Medical University during January 2018 to October 2019，and then divided into control group （39 cases）and observation group （44 cases）. Control group was given Oxcarbazepine tablet with initial dose of 8-10 mg/（kg·d），morning and night ，increased by 5-10 mg/（kg·d）each week according to patient ’s condition ，the maximal dose was 45 mg/（kg·d），lasting for 3 months with the lowest effective treatment dose. Based on treatment of control group ，observation group was additionally given Levetiracetam tablet with initial dose of 5-10 mg/（kg·d），morning and night ，increased by 5-10 mg/（kg·d）each week according to the severity of disease，the total dose was not more than 2 000 mg/d，lasting for 3 months with the lowest effective treatment dose. The event-related potential P 300 at Pz site in 2 groups was measured before and after treatment （including the incubation period of N 1， P2，N2 and P 3 waves，amplitude of P 3 wave）. Webster ’s Adult Intelligence Scale [WAIS-RC ，including verbal IQ （VIQ）， performance IQ （PIQ），full scale IQ （FIQ）scores] and Clinical Memory Scale [CMS ，converting to memory quotient （MQ） score] were adopted. The occurrence of ADR was recorded. RESULTS ：Totally 5 patients of control group and 7 patients of observation group fell off. Finally ，a total of 71 patients participated in the entire study （34 cases in control group and 37 cases in observation group ）. Before treatment ，there was no statistical significance in P 300 at Pz site ，WAIS-RC and CMS between 2 groups （P＞0.05）. Compared with before treatment ，incubation period of N 2 and P 3 waves was shortenedsignificantly in 2 groups，and amplitude of P 3 wave wasincreased significantly after treatment （P＜0.05）；VIQ，FIQ and MQ scores were increased significantly （P＜0.05）. The incubation pe riod of P 2 wave was shortened significantly，and PIQ score was increased significantly in observation group （P＜ 0.05）. Compared with control group ，the shortening degree of incubation period of P 2，P3 waves，rising degree of amplitude of P 3 wave and rising degree of VIQ ，PIQ，FIQ，MQ scores were more bigger after treatment in observation （P＜0.05）. In the control group，there was 1 case of slight rash ，1 case of conscious asthenia ；in the observation group ，there was 1 case of nausea and vomiting，1 case of conscious asthenia ，and 1 case of emotional instability ；no serious ADR was found in 2 groups. CONCLUSIONS：Oxcarbazepine combined with levetiracetam can improve cognitive dysfunction in adult patients with temporal lobe epilepsy ，and the treatment effect is significantly better than oxcarbazepine monotherapy.