Effects of lacosamide combined with levetiracetam on neurological function and clinical efficacy in children with epi-lepsy

Xie Xiaohui; Zhu Yan; Zhao Ting; Teng Wei; Amanguli

doi:10.3969/j.issn.1671-6450.2024.05.008

Abstract：Objective To investigate the effectiveness of the combination of lacosamide and levetiracetam in man-aging epilepsy in children,as well as its impact on serum BDNF,PGP,and other neurological function-related parameters.Methods During the period from January 2021 to July 2022,a total of 120 children diagnosed with primary epilepsy were enrolled from the Pediatrics Department of People's Hospital of Xinjiang Uygur Autonomous Region.These patients were randomly allocated into two groups:the observation group(n=60)and the control group(n=60).The children in the con-trol group were given routine support therapy and oral treatment with levetiracetam,while the children in the control group received standard treatment,lacosamide tablets were administered to the children in the observation group on top of that,and all children were treated continuously for6 months.A comparison was made between the two groups in terms of thera-peutic effects and the occurrence of adverse events,and the changes of neurological function related indexes(MBP,S-100β,HMGB1,GFAP,PGP),epileptic seizure were compared between the two groups before and after treatment.Results The ob-servation group exhibited a significantly higher overall effectiveness rate(98.33%vs.90.00%,χ2/P=4.184/0.041),while the average number of seizures and duration of seizures were lower than those in the control group(t/P=13.288/<0.001,2.956/0.002),although there were no significant differences in the occurrence of adverse events between the two groups(P>0.05).The levels of serum MBP,S-100β,HMGB1,GFAP,and PGP considerably decreased in the observed group after treatment,in comparison to the pre-treatment and control group levels.Meanwhile,the level of BDNF in the observed group notably in-creased in comparison to the pre-treatment and control group levels(t/P=2.858/0.005,4.672/<0.001,2.142/0.034,3.521/<0.001,5.054/<0.001,10.310/<0.001).Correlation analysis indicated a positive relationship between the number of post-treat-ment seizures in children with epilepsy and the serum PGP level,while a negative correlation was observed with the BDNF level(r/P=0.577/<0.001,-0.338/<0.001).Conclusion Lacosamide combined with levetiracetam can significantly improve the related indexes of neurological function in children with epilepsy,so as to reduce the frequency of epileptic seizures and improve the efficiency of treatment.And the clinical safety of the treatment scheme is good,and it has a broad clinical appli-cation prospect for children with epilepsy.