Abstract
Levetiracetam (LEV) and oxcarbazepine (OXC) are commonly used in the treatment of epilepsy, but their efficacy and safety have seldom been compared for the treatment of children with benign epilepsy with centrotemporal spikes (BECTS). We thus assessed the efficacy of LEV and OXC monotherapy in the treatment of children with BECTS, and the effect of this treatment on children’s intelligence and cognitive development. This was a randomized, single-center trial. Children with BECTS were randomized (1:1) into LEV and OXC groups, and were assessed at 1, 3 and 6 months after treatment. The primary outcomes were the frequency of seizures and changes in intelligence and cognitive function. Secondary outcomes were electroencephalogram (EEG) results and safety. Seventy children were enrolled and randomized to the LEV group or the OXC group, and 32 of the 35 children in each group completed the study. After 6 months, the effective treatment rate of the OXC group was significantly higher than that of the LEV group (78.12 vs. 53.12%, p = 0.035). However, no significant inter-group difference was observed in EEG improvement (p = 0.211). In terms of intelligence and cognitive development, children in the OXC group exhibited significantly improved choice reaction time, mental rotation, and Wisconsin Card Sorting Test results (all p < 0.05). Both LEV and OXC were well tolerated, with 18.75 and 21.88% of children reporting mild adverse events (p = 0.756). OXC monotherapy was more effective than LEV for children with BECTS. In addition, children with OXC monotherapy had higher improvements in children’s intelligence and cognitive function than those with LEV monotherapy.
Highlights
Epilepsy is a chronic transient brain dysfunction syndrome caused by the abnormal electrical discharge from neurons in the brain that may affect children’s physical, intellectual and mental health [1]
Compared with pre-intervention, word semantics, Raven’s Progressive Matrices, visual tracing, and Wisconsin Card Sorting Test were significant improved after intervention for patients in both LEV and OXC group, and significant improvement were further observed for choice reaction
We investigated the efficacy of LEV and OXC monotherapy in the treatment of children with Benign epilepsy with centrotemporal spikes (BECTS), and the effects of these treatments on their intellectual and cognitive development
Summary
Epilepsy is a chronic transient brain dysfunction syndrome caused by the abnormal electrical discharge from neurons in the brain that may affect children’s physical, intellectual and mental health [1]. BECTS is an idiopathic focal epilepsy syndrome that has a good prognosis, and generally does not affect growth and development [4]. Levetiracetam (LEV), as a typical second-generation AED for BECTS, is a derivative of pyrrolidone that selectively combines with synaptic vesicle protein 2A to promote vesicle aggregation and subsequent vesicle discharge from cells. This regulates neurotransmitter release and inhibits abnormal electrical discharge from neurons, thereby resulting in antiepileptic effects [7]. Due to its low induction by liver enzymes, high bioavailability and low protein-binding rate [10], OXC has been suggested to have similar efficacy to carbamazepine, but superior tolerability and safety [11]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
