奥卡西平和卡马西平对成人部分性癫痫认知功能及脑电图的影响

摘要

目的 比较奥卡西平和卡马西平对成人部分性癫痫患者认知功能及脑电图的影响.方法 符合诊断标准的成人部分性癫痫患者,随机分为卡马西平治疗组(n=64)和奥卡西平组(n=92),进行单药治疗.分别于治疗前及治疗后6个月行认知功能测评及长程视频脑电图(VEEG)检查.分析2组治疗前后认知功能及脑电图的变化.结果 部分性癫痫患者经奥卡西平或卡马西平单药治疗6个月后,韦氏成人智力量测评提示奥卡西平组认知功能较治疗前有所改善,卡马西平组治疗前后变化不明显;脑电图检查示治疗6个月后,奥卡西平组有73.9%的患者癫痫样放电减少超过50%,卡马西平组只占53.1%,2组差异有统计学意义(P<0.05);卡马西平组治疗后α功率值较治疗前显著降低(P<0.05),θ功率值显著增加(P<0.05),奥卡西平组治疗前后α功率值无明显改变(P>0.05),θ功率值明显增加(P<0.05).结论 奥卡西平与卡马西平相比,对成人部分性癫痫患者认知功能改善更明显,对痫样放电的抑制作用较强,且对脑电背景活动影响较小%Objective To compare the effects of oxcarbazepine( OXC ) and carbamazepine( CBZ ) on cognitive function and EEG in adult patients with partial epilepsy. Methods A total of 156 patients with partial epilepsy were randomly divided into OXC treatment group( n =64) and CBZ treatment group( n = 92 ), and the patients in the two groups were treated with OXC or CBZ, respectively. The patients cognitive function assessment and long-term VEEG examination were performed before and after drug treatment. The changes of cognitive function and EEG were compared and statistically analyzed for both groups. Results After 6-month treatment with OXC or CBZ,WAIS-RC assessment showed that the cognitive function in OXC treatment group was obviously improved, however,the improvement in CBZ treatment group was not obvious. The examination results of EEG showed that after 6-month treatment with OXC or CBZ, there were 73. 9% of patients in OXC group whose epileptiform discharge was decreased over 50% ,but only 53. 1% of patients in CBZ group, there was a significant difference between two groups( P < 0. 05 ). After treatment the apower value in CBZ group was obviously decreased, however, 0power value was significantly increased. But after treatment the apower value in OXC group was not obviously changed,however,the 0power value was significantly increased. Conclusion As compared with CBZ, OXC can obviously improve cognitive function of adults patients with partial epilepsy, which has effective inhibitory effect on epileptiform discharge,however, which has little influence on the background activity of EEG.