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.
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。