Abstract：
The neonatal and infantile period is the age group with the highest incidence of epilepsy, in which gene variants in sodium and potassium channels are an important etiology, so the sodium channel blocker class of antiseizure medications may be effective in the treatment of early onset epilepsy. This study aimed to summarize the efficacy and tolerability of oxcarbazepine (OXC) in the treatment of focal epilepsy in neonates and infants under 3 months of age.
A retrospective analysis of children with focal epilepsy onset within 3 months of age and treated with OXC in a tertiary pediatric epilepsy center in China was conducted. The efficacy, tolerability and influencing factors of OXC were evaluated.
A total of 50 patients were enrolled, with a median age of epilepsy onset of 11.5 (2, 42) days. There were 32 cases of early infantile developmental and epileptic encephalopathy, 10 cases of self-limited neonatal or neonatal-infantile epilepsy, and 8 cases of focal epilepsy that could not be classified as epileptic syndrome. The median age of application of OXC was 47 (31, 66) days. The median follow-up time was 16.5 (10, 25) months, with 7 deaths. Thirty-eight cases (76.0 %) were effective with OXC treatment, including 28 cases (56.0 %) achieved seizure freedom. Of the 34 cases whose pathogenesis involved genetic factors, 19 cases with sodium/ potassium channel gene variants had higher effective and seizure-free rates than those with other gene variants. The most common adverse event was transient hyponatremia. 2 cases had rash and 2 cases had abnormal electrocardiogram, 3 of which discontinued OXC.
This single-center retrospective study suggests that OXC is effective and tolerable for the treatment of focal epilepsy in neonates and infants under 3 months of age. The efficacy of OXC is better in patients with sodium/ potassium channel gene variants.
A retrospective analysis of children with focal epilepsy onset within 3 months of age and treated with OXC in a tertiary pediatric epilepsy center in China was conducted. The efficacy, tolerability and influencing factors of OXC were evaluated.
A total of 50 patients were enrolled, with a median age of epilepsy onset of 11.5 (2, 42) days. There were 32 cases of early infantile developmental and epileptic encephalopathy, 10 cases of self-limited neonatal or neonatal-infantile epilepsy, and 8 cases of focal epilepsy that could not be classified as epileptic syndrome. The median age of application of OXC was 47 (31, 66) days. The median follow-up time was 16.5 (10, 25) months, with 7 deaths. Thirty-eight cases (76.0 %) were effective with OXC treatment, including 28 cases (56.0 %) achieved seizure freedom. Of the 34 cases whose pathogenesis involved genetic factors, 19 cases with sodium/ potassium channel gene variants had higher effective and seizure-free rates than those with other gene variants. The most common adverse event was transient hyponatremia. 2 cases had rash and 2 cases had abnormal electrocardiogram, 3 of which discontinued OXC.
This single-center retrospective study suggests that OXC is effective and tolerable for the treatment of focal epilepsy in neonates and infants under 3 months of age. The efficacy of OXC is better in patients with sodium/ potassium channel gene variants.
摘要：
目的：新生儿和婴儿期是癫痫发病率最高的年龄组，其中钠和钾通道的基因变异是重要的病因，因此钠通道阻滞剂类抗癫痫药物可能有效治疗早发性癫痫。本研究旨在总结奥卡西平(OXC)治疗新生儿和3月龄以下婴儿局灶性癫痫的疗效和耐受性。
方法：对中国某三级小儿癫痫中心3月龄内局灶性癫痫发作并接受OXC治疗的患儿进行回顾性分析。功效,对OXC的耐受性和影响因素进行评价。
结果：共纳入50例患者，癫痫发作的中位年龄为11.5（2，42）天。32例早期婴儿发育性脑病和癫痫性脑病,10例新生儿自限性或新生儿癫痫,8例不能归类为癫痫综合征的局灶性癫痫。应用OXC的中位年龄为47(31，66)天。中位随访时间为16.5(10,25)个月,7人死亡OXC治疗有效38例(76.0%),包括28例(56.0%)实现了癫痫发作自由。在发病与遗传因素有关的34例中，19例钠/钾通道基因变体的有效和无癫痫发作率高于其他基因变体的患者。最常见的不良事件是短暂性低钠血症。2例出现皮疹,2例出现心电图异常,其中3家停产了OXC。
结论：这项单中心回顾性研究表明，OXC治疗新生儿和3个月以下婴儿局灶性癫痫是有效和可耐受的。OXC在钠/钾通道基因变异的患者中疗效较好。
方法：对中国某三级小儿癫痫中心3月龄内局灶性癫痫发作并接受OXC治疗的患儿进行回顾性分析。功效,对OXC的耐受性和影响因素进行评价。
结果：共纳入50例患者，癫痫发作的中位年龄为11.5（2，42）天。32例早期婴儿发育性脑病和癫痫性脑病,10例新生儿自限性或新生儿癫痫,8例不能归类为癫痫综合征的局灶性癫痫。应用OXC的中位年龄为47(31，66)天。中位随访时间为16.5(10,25)个月,7人死亡OXC治疗有效38例(76.0%),包括28例(56.0%)实现了癫痫发作自由。在发病与遗传因素有关的34例中，19例钠/钾通道基因变体的有效和无癫痫发作率高于其他基因变体的患者。最常见的不良事件是短暂性低钠血症。2例出现皮疹,2例出现心电图异常,其中3家停产了OXC。
结论：这项单中心回顾性研究表明，OXC治疗新生儿和3个月以下婴儿局灶性癫痫是有效和可耐受的。OXC在钠/钾通道基因变异的患者中疗效较好。
