Cognitive and eeg changes in post-stroke epilepsy patients:effects of valproate and olanzapine
Wei Jia
Chen Xin
Li Xiao-qing
Fan Jia
Yin Shao-hua
Abstract：Objective To study the effect of sodium valproate combined with oxiracetam on serum nerve cell factor level and EEG in elderly patients with post-stroke epilepsy(PSE).Methods From January 2022 to August 2023,82 elderly patients with PSE admitted to Xingtai People's Hospital were divided into group A and group B by random number table method.Forty-one pa-tients in the group A were treated with sodium valproate sustained-release tablets.Forty-one patients in the group B were treated with oxiracetam capsules on the basis of the group A.Group A and group B were treated for 3 months and followed up for 1 year.The clinical efficacy,symptom control,serum nerve cell factor level,electroencephalogram index and adverse reactions of the group A and group B were compared and analyzed.Results After treatment,the total effective rate of group B was 92.68%(38/41),which was higher than 75.61%(31/41)of group A(χ2=4.479,P=0.034).During follow-up,the duration of seizures and the number of sei-zures in group B and group A((1.86±0.17)min·time-1,(0.73±0.15)times·year-1 and(2.98±0.21)min·time-1,(0.96±0.24)times·year-1)were lower than those before treatment((5.09±0.42)min·time-1,(3.50±0.62)times·year-1 and(5.21±0.35)min·time-1,(3.35±0.44)times·year-1),and group B was lower than group A(t=26.543,5.204,respectively,both P<0.05).After treatment,the levels of serum neuron-specific enolase(NSE)and glial fibrillary acidic protein(GFAP)in the group B and group A((6.77±1.32)μg·L-1,(1.85±0.43)ng·L-1 and(10.52±2.18)μg·L-1,(2.41±0.59)ng·L-1,respectively)were lower than those before treatment((23.64±4.03)μg·L-1,(3.85±0.66)ng·L-1 and(24.17±4.51)μg·L-1,(3.68±0.72)ng·L-1,respectively),the levels of serum brain-derived neurotrophic fac-tor(BDNF)((11.33±2.57)μg·L-1 and(7.25±1.94)μg·L-1)were higher than those before treatment((4.27±0.69)μg·L-1 and(4.59±0.77)μg·L-1),and the levels of serum NSE and GFAP in group B were lower than those in group A,and the level of serum BDNF was higher than that in the group A(t=9.422,4.912,8.113,respectively,all P<0.05).After treatment,the number of epileptiform dis-charges and involved leads in group B and group A((7.88±1.25)t·180 s-1,(5.05±1.16)180 s and(9.76±1.40)t·180 s-1,(5.97±1.46)180 s,respectively)was lower than that before treatment((16.33±2.79)t·180 s-1,(8.58±1.51)180 s and(15.62±2.41)t·180 s-1,(8.21±1.42)180 s,respectively),and group B was lower than group A(t=6.414,3.159,respectively,both P<0.05).The total incidence of adverse reactions in the group A was 12.20%(5/41),and that in the group B was 17.07%(7/41).There was no significant difference between the group A and group B(χ2=0.390,P=0.532).Conclusion Oxiracetam combined with sodium valproate has a good clin-ical effect in the treatment of elderly patients with PSE.It can regulate the level of serum neurocytokines,which is helpful to improve the clinical symptoms and EEG indexes of patients,and has good safety.
Keywords：StrokeEpilepsyOxiracetamSodium valproateOld age
Publication Date：2025-04-25
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 198-201 )