• Department of Neurology, Children’s Hospital Affiliated to Chongqing Medical University; National Clinical Medical Research Center for Child Health and Disease; Key Laboratory of Child Developmental Disease Research of Ministry of Education; National International Science and Technology Cooperation Base for Major Childhood Developmental Diseases ; Chongqing Key Laboratory of Pediatrics, Chongqing 400014, China;
HU Yue, Email: huyue915@163.com
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Objective To systematically evaluate the efficacy of steroids combined with antiepileptic drugs compared with alone antiepileptic drugs in the treatment of children with epileptic electrical status during sleep to provide evidence-based medical basis for its treatment.Methods Electronic searches were maded in PubMed, Embase database, Cochrane Library, CNKI, Wanfang and the Chinese biomedical literature database for the literature about steroids combined with antiepileptic drugs compared with alone antiepileptic drugs in the treatment, and retrieval time is from January 1990 to October 2020. Two evaluators independently screened literature, extracted data, evaluated literature quality and risk of bias and checked each other. Meta analysis was performed by stata16.0 software.Results A total of 679 children with ESES were included in 10 studies, including 9 randomized controlled trials and 1 retrospective cohort study. Meta analysis results showed that there were statistically significant differences in clinical improvement rate [RR=1.31, 95%CI (1.21, 1.42), P<0.01], electroencephalogram discharge improvement rate [RR=1.35, 95%CI (1.25, 1.46), P<0.01] and cognitive intelligence score [SMD=1.19, 95%CI (0.80, 1.57), P<0.01] between steroids combined with antiepileptic drugs group and alone antiepileptic drugs group after 6 months follow-up. The incidence of adverse reactions in steroids combined with antiepileptic drugs group was higher than that in alone antiepileptic drugs group, and the difference was statistically significant [RR=4.13, 95%CI (1.06, 16.13), P<0.01]. All adverse reactions improved or disappeared after drug withdrawal.Conclusion Compared with alone antiepileptic drugs, steroids combined with antiepileptic drugs group has advantages in controlling epileptic seizures, improving electroencephalogram abnormalities and improving cognitive ability, and it is relatively safe.

Citation: TANG Lanfang, HU Yue. A Meta-analysis of effectiveness and safety of steroids combined with antiepileptic drugs in the treatment of children with epileptic electrical status during sleep. Journal of Epilepsy, 2021, 7(3): 197-207. doi: 10.7507/2096-0247.20210032 Copy

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