Levetiracetam治療癲癇病患之療效、生活品質、認知功能、心理與情緒之研究

Abstract

Objective: Epilepsy is a chronic neurologic disease. Not only the disease itself, but also the treatment may have a significant impact on patient’s quality of life, cognitive function, psychological and emtional status. Levetiracetam is the newest anti-epileptic drugs (AEDs) in Taiwan, and it has good efficacy, unique mechanism of action from other AEDs and good tolerablility for patients. Therefore, it is often used as alternative drug because of the lack of efficacy or poor tolerability of their current AEDs. The objective of the study was to assess the impact of LEV on quality of life, cognitive function, psychological and emotional status in Taiwanese patients who their current AEDs have poor efficacy or poor tolerability and also assess its efficacy on seizure control. Method: This perspective, open-label, signle-arm observational study is conducted in National Taiwan University Hospital, Chang Gung Memorial Hospital Changhua Christian Hospital and Hualien Tzu Chi General Hospital. The patients who are recruited should meet one of the following inclusion criterions: minimal seizure frequency should be equal or more than 4 times in past one year regardless of seizure types, or can’t tolerate current AEDs. All of the patients will be gived LEV treatment and administrated the QOLIE-10, MMSE and SCL-90R to assess their quality of life, cognitive function, and psychological and emotional status, respectively in baseline and three- month treatment end. Result: For all 77 patients who completed the QOLIE-10, MMSE and SCL-90R, at baseline and 3 month treatment period, a significant improvement was noted in quality of life, cognitive function, psychological and emotional stautus. The performance of patients in 「social function」, 「cognitive function」,「medicational effect」and 「total score」 QOLIE-10 subitems were statistically improved. Furthermore , patients’ cognitive function in 「short term memory」「language comprehension」「total score 」in MMSE were also found improved significantly. Finally, 「obessive compulsive disease」「depression」and「anxiety」in SCL-90R, patients were also improved significantly. In addition, the seizure frequency (median) was reduced from 7 to 3 in three-month periods. In addition, the number of AEDs concurrent used and LEV efficacy had significant impact on patient’s improvement in quality of life. However, the improvement in cognitive function, psychological and emotional status may be probably because of the nature of the LEV. Conclusion: LEV controlled seizure attacks in epileptic patients in Taiwan. Furthermore, after treatment of LEV, quality of life, cognitive function, psychologic and emotional status of patients significantly improved.