ObjectiveTuberous sclerosis complex (TSC) is a multiorgan disorder and mostly associated with intractable epilepsy. Now several individual reports suggest that epilepsy in children with TSC might benefit from a ketogenic diet (KD). We prospectively studied the curative effect of 14 children with the KD in the treatment of TSC with epilepsy. MethodsBetween 2008 and 2015, we enrolled 14 children with TSC and epilepsy who received KD treatment in Shenzhen Children's Hospital and followed up for at least three months.Outcome was measured by the change of seizure frequency before and after the KD in the use of anticonvusant drugs, adverse effects, and change in cognitive function. Results14 children aged 8 months to 7 years were included. 7/14 (50%) children had a > 50% reduction in seizure frequency at 3 months on the diet, 5/14 (36%) children had a seizure free response. 12/14 (86%) children with refractory epilepsy, 6/12 (50%) children had a > 50% reduction in seizure frequency, 2 children had reduced medications, one child did not use any antiepileptic drugs during KD. 6 of 12 children with developmental delays had cognitive function improvement. ConclusionsKD is a generally effective and safe therapy for TSC children with epilepsy, especially for refractory epilepsy. KD could reduce antiepileptic drugs, and also improve children's cognitive function.
ObjectiveUsing retrospective study to analyze the data of 112 patients with benign childhood epilepsy with centrotemporal spikes (BECTS) and investigate the clinical characteristics and provide some clinical experience in treatment. MethodsWe collected the medical records of 112 cases of BECTS children in the First Affiliated Hospital of Guangxi Medical University of children's clinics from January 2011 to December 2012. According to whether taking antiepileptic drugs (AEDs) treatment regularly, the 112 cases with BECTS was divided into the treated group and the non-treated group, then analyzed the clinical characteristics between the two groups retrospectively, including age of onset, single episode duration, frequency of seizure, pattern of seizure and EEG performances. ResultsThrough regular AEDs treatment, the duration of a single attack was shortened, generalized tonic-clonic seizure(GTCS) was decreased significantly in the treatment group (P < 0.05). For patients whose seizure frequency was≥3 times/3 months, AEDs could effectively control or reduce their seizure frequency (P < 0.05), while AEDs had no obvious effect on the seizure frequency of those whose seizure frequency was≤2 times/3 months (P > 0.05). In the treatment group, 29 cases whose age < 7 controlled their epilepsy attacks after taking AEDs for average of 13.76 months, while 35 cases whose age≥7 controlled their epilepsy attacks after taking AEDs for average of 6.36 months. Conclusion①BECTS patients with a long duration of a single attack and seizure frequency more than 3 times/3 months could be effectively controlled after receiving early AEDs treatment.②The younger age of onset (< 7 years old) required longer AEDs treatment to control seizures.
Objective To systematically review and analyze the risk factors of epilepsy in children, to explore the related etiology of epilepsy in children, and to provide evidence-based strategies for reducing the occurrence of epilepsy in children. Methods PubMed, Embase, VIP, CNKI, Web of science, Cohrane, and CBM were searched for relevant studies on risk factors for childhood epilepsy since the establishment of the database, and the study type was selected as a case-control study. After screening and quality evaluation, the literatures that met the requirements were finally selected for inclusion in the study, and the extracted target data were statistically analyzed by RevMan5.3 software. Results A total of 9 literatures were included for Meta-analysis of the risk factors of epilepsy in children. A total of 3792 cases were studied, including 1 922 cases in the control group and 1 870 cases in the case group. Meta-analysis results showed that adverse perinatal period, family history of epilepsy, febrile seizures, and central nervous system infection were closely related to the occurrence of epilepsy in children, and the OR values were OR=3.46, 95%CI (2.51, 4.79), OR=4.77, 95%CI (3.83, 5.95), OR=7.81, 95%CI ( 5.64, 10.80), OR=3.00, 95%CI (1.44, 6.26), P values were all less than 0.05. Conclusions Adverse perinatal period, family history of epilepsy, febrile seizures, and central nervous system infection are the current risk factors for childhood epilepsy.
Perampanel (PER) is a third-generation novel anti-seizure drug, a postsynaptic neuronal (α-Amino-3-hydroxy-5-methyl-4- isoxazolepropionic acid, AMPA) receptor antagonist, which effectively controls seizures by inhibiting glutamate-induced neurological hypertransmission. PER can not only be used for the addition of focal epilepsy 4 years old and above, but also monotherapy for children (≥ 4 years old) for the treatment of focal epilepsy patients, its efficacy and safety is relatively good, has been used clinically in many countries, the article overviewed the pharmacokinetics, mechanism, and the addition and monotherapy in different epilepsy types of childhood epilepsy and other aspects, in order to provide a reference for clinical medication, and provide individualized treatment for children with epilepsy.
Objective We aimed to develop a self-management assessment scale for children with epilepsy and test its reliability and validity. Methods A research group was established, and the items were revised through literature review, group discussion and pre-investigation, and 280 patients with epilepsy in children were included, and the reliability and validity of the scale were tested. Results 28 items in 4 dimensions were developed to form the scale, namely, knowledge and belief of diseases and medication, compliance of medication and treatment, self-efficacy of medication and obstacles of medication. Confirmatory factor analysis extracted four common factors with characteristic roots greater than 1, and the cumulative variance explanation rate was 65.639%. The factor load of all items is > 0.5. The overall Cronbach’s alpha is 0.880, and the coefficients in seven measurement dimensions are all greater than 0.8. Conclusion The self-management assessment scale for children’s epilepsy drugs has good reliability and validity, and can provide a measuring tool for the drug management of children’s epilepsy diseases.