Objective To investigate the influence of Lamotrigine (LTG) on sex hormone, seminal fluid and sexual function in male epilepsy patients. Methods The blood sex hormone levels and sperm quality were detected in 20 normal controls and 16 male epilepsy patients in Epilepsy Center of Sichuan Province People's Hospital from April 2015 to November 2016. All participants were detected before taking medicine and after being treated with LTG monotherapy for 1 year. The international index of erectile function-5 (IIEF-5) was employed to assess the sexual function in the groups above, and the results were compared. Results Compared with the control group, the total number of sperm, the rate of forward movement, survival, normal sperm and the score of IIEF-5 in the untreated group were less (P<0.05). LTG treatment group's sperm parameters and the score of IIEF-5 seemed improve, but there was no statistically significant difference (P>0.05). There was no significant difference in sexual hormones between the groups above (P>0.05). Conclusions Semen quality and the score of IIEF-5 in epileptic male decline more easily; LTG might improve the semen quality and sexual function, but no significant difference has being found.
Objectives To investigate the effects of new antiepileptic drugs [oxcarbazepine (OXC), levetiracetam (LEV), lamotrigine (LTG)] on thyroid hormones in male adults with epilepsy. Methods Thirty-eight newly diagnosed male adult patients with epilepsy were enrolled in the Epilepsy Center of Sichuan Province People's Hospital from April 2015 to November 2016. The diagnosis was in line with the classification of epilepsy defined by the International League Against Epilepsy (ILAE, 1981). Only patients with generalized or secondary generalized epilepsy were recruited into the present study. Individual treatment with OXC, LEV, or LTG was randomly assigned to the 38 patients. Thyroid hormones was measured before treatment and 6 months after taking the medicine. Followed by an analysis of the comparison between the treated patients and healthy volunteers (healthy controls) as well as the changes and differences between the patients themselves before and after treatment. Results There was no significant difference in the thyroid hormone levels between male patients with epilepsy before taking the medicine and healthy controls (P>0.05). After 6 months, total thyroxine (TT4) and free thyroxine (FT4) in OXC group was significantly lower than the baseline (P<0.05). However, the thyroid hormone levels in the LEV group and LTG group showed no statistical difference before and after treatment (P>0.05). Conclusions OXC can reduce serum total thyroxine (TT4) and free thyroxine (FT4), which might be harmful to thyroid hormone of patients.
ObjectiveTo explore the status of common comorbidities in adult epilepsy patients in western China, and to explore the related risk factors.MethodsThe Chinese version of Generalized Anxiety Disorder (GAD)-7, neurological disorders depression inventory for epilepsy (NDDI-E) scales, pittsburgh sleep quality index scale (PSQI) and epworth sleepiness scale (ESS) were used to evaluate the 199 epilepsy patients between April 2017 and March 2018 in the Epilepsy Center of Neurology Department of Sichuan People's Hospital. Logistic regression analysis was performed on the risk factors of epilepsy comorbidity.ResultsIn the 199 adult epilepsy patients, 28.1% had anxiety, 17.1% had depression, 33.2% had sleep disorder, and 2.5% had migraine. 140 patients received monotherapy, including 15 patients with carbamazepine (CBZ), 20 patients with lamotrigine (LTG), 26 patients with levetiracetam (LEV), 31 patients with topiramate (TPM), 25 patients with oxcarbazepine (OXC), and 23 patients with Valproate (VPA).Multivariate logistic regression analysis of epilepsy patients treated with monotherapy showed that seizure occurring more than once a month, LEV, TPM, sleep disorders were independent risk factors for anxiety in patients with epilepsy (P<0.05). Unemployment, seizure occurrence in the last three months, sleep disorders were independent risk factors for comorbid depression (P<0.05). Anxiety, depression, daytime sleepiness, CBZ, LTG were independent risk factors for comorbid sleep disorders (P<0.05).ConclusionsAnxiety, depression and sleep disorder are common comorbidities in adults with epilepsy in westChina. For patients with affective disorder and sleep disorder, early identification and intervention may be important to improve the quality of life and prognosis of patients. In addition, patients treated with LEV or TPM monotherapy had a higher risk of anxiety than other drugs. Patients with LTG and CBZ monotherapy are more likely to comorbid sleep disorders.
ObjectiveTo retrospectively study the acute epileptic seizures of patients with anti-N-methyl-D-aspartate receptor (anti-NMDAR)and anti-leucine-rich glioma-inactivated 1(anti-LGI1)encephalitis. The characteristics and short-term prognosis provide reference for early clinical diagnosis and treatment.MethodsThe patients with anti-NMDAR and anti-LGI1 encephalitis who were admitted to the Department of Neurology of Sichuan Provincial People’s Hospital from January 2018 to June 2020 were continuously included. The general information, clinical manifestations, acute seizures and types of seizures were reviewed and analyzed.To evaluate the difference between the characteristics of two kinds of autoimmune encephalitis in the acute phase of seizures and the short-term prognosis.ResultsA total of 75 patients with anti-NMDAR encephalitis and anti-LGI1 encephalitis (41 males and 34 females) were included, of which average ages are(32.8±17.9)years, average courses are(1.8±1.1)months.59 and 16 are respectively positive for anti-NMDAR and anti-LGI1 antibodies, respectively. Of the 75 cases, 56 cases (74.7%) had seizures in the acute phase. Among the 56 cases of seizures, 38 cases (67.8%) were accompanied by disturbances of consciousness, 5 cases (8.9%) of autonomic dysfunction, and 24 cases of decreased oxygenation capacity. (42.9%) and 20 cases (35.7%) who were admitted to NICU, there was a significant statistical difference compared with the seizure-free group (P<0.05). The median age of anti-NMDAR encephalitis in the acute stage of seizures was 23 years, and that of anti-LGI1 encephalitis was 56.5 years (P<0.05). Anti-NMDAR encephalitis and anti-LGI1 encephalitis are common in the acute phase of epileptic seizures (55.9%vs.53.8%). Anti-NMDAR encephalitis has more frequent seizures and status epilepticus in the acute phase (P<0.05). After early and rational use of anti-epileptic drugs(AEDs) and immunotherapy and other symptomatic and supportive treatments, 70% of 56 patients were effectively controlled for seizure. Follow-up 3 months later, 18 patients (32.1%) stopped using anti-epileptic drugs (AEDs), While 30 patients (53.5%) continued to receive AEDs treatment, of which 25 patients (44.6%) had no seizures.ConclusionBoth anti-NMDAR encephalitis and anti-LGI1 encephalitis have a higher risk of seizures in the acute phase. Patients with seizures are more likely to have disturbances in consciousness, decreased oxygenation capacity, and higher rates of admission to NICU. Anti-NMDAR encephalitis is more common in young people around 30 years old, and anti-LGI1 encephalitis is more likely to develop around 60 years old. Patients with anti-NMDAR encephalitis are more likely to have abnormal electroencephalograms, have a longer average hospital stay, and are more likely to have recurrent seizures and status epilepticus in the acute phase. After timely diagnosis and intervention treatment, most patients' seizures can be well controlled. After the acute phase, AEDs can be withdrawed in one third of patients.
Objective To assess the effect of naloxone in treating the disease of acute cerebral infarction. Methods Sixty patients of acute cerebral infarction were randomly divided into two groups. One group received routine therapy and the other routine therapy plus naloxone. Neuroprotective effect of naloxone were measured by using NIH stroke scale and Bathel-Index. Adverse effect of the drug was also observed. Results There were 27 patients (90%) improved with clinical manifestations in experiment group, and 20 patients (67%) improved in control group. There is a significant difference between the two groups (Plt;0.05).There is no adverse reactions of naxloxone observed. Conclusion Naloxone might protect the nervous cells and restore the function of the nervous system in patients with acute cerebral infraction.
Objective The study was performed to compare the efficacy and effect on quality of life of sodium valproate (VPA) sustained-release tablets versus topiramate (TPM) in newly diagnosed adult symptomatic epilepsy. Methods This is aprospective, randomized controlled trial on 200 patients newly diagnosed as adult symptomatic epilepsy in Sichuan Province People’s Hospital druing September 2014 to December 2016. The patients were randomly divided into VPA group (n=110) and TPM group (n=90). Then we evaluated the efficacy, retention rate, adverse reactions, and quality of life of the two groups after one year of treatment. Results The total effective rate of VPA group was 69.1%, and the rate of no seizures was 38.2%; the total effective rate of TPM was 62.2%, and the rate of no seizures was 42.2%. No statistically significant difference in the effective rate and no seizure rate was found between the two groups. There was no statistical difference in the retention rate between the two groups(69.1% vs. 65.6%, P>0.05) . The incidence of adverse reactions of VPA was significantly lower than that of TPM (9.1%vs. 20%, P<0.05). The quality of life of the two groups was significantly improved from baseline before treatment. VPA group showed significantly better performance than TPM group on mood and cognitive improvement (P<0.05). Conclusion ① There was no significant difference in efficacy and retention rate between VPA sustained-release tablet and TPM on adult patients with symptomatic epilepsy after one year's treatment; ② The incidence of adverse reactions of TPM group was significantly higher than that of VPA group; ③ VPA sustained-release tablets and TPM can significantly improve the overall quality of life of patients, and VPA sustained-release tablets is significantly better than topiramate on the improvement of emotional and cognitive function.
Objective To evaluate the clinical efficacy and safety of imported and domestic oxiracetam injection in the treatment of acute cerebral infarction. Methods Between March 2013 and July 2014, a multicenter randomized blind controlled clinical study was conducted to learn the clinical efficacy and safety of imported oxiracetam injection (produced by Korea Pharmaceutical Corporation) and domestic oxiracetam injection (named as Oulantong, produced by Harbin Medisan Pharmaceutical Co., Ltd) in the treatment of acute cerebral infarction. West China Hospital of Sichuan University was in charge of the study, and the participants included the People’s Hospital of Guangxi Zhuang Autonomous Region, Affiliated Hospital of Guilin Medical University, Department of Neurology of Jilin Provincial People’s Hospital, the Second Affiliated Hospital of Kunming Medical University, the First Hospital of Lanzhou University, Sichuan Academy of Medical Sciences & Sichuan Provincial People’s Hospital, the First Affiliated Hospital of Soochow University, the First Affiliated Hospital of Tianjin University of TCM, Chongqing Three Gorges Central Hospital, and the Second Affiliated Hospital of Soochow University. A total of 240 patients with acute cerebral infarction were randomly divided into trial group (basic treatment plus imported oxiracetam injection) and control group (basic treatment plus domestic oxiracetam) with 120 patients in each. Follow-up was conducted 1 week, 2 weeks and 12 weeks after treatment. Finally, 200 patients consistent with the study criteria were included, including 101 in the trial group and 99 in the control group. National Institute of Health Stroke Scale (NHISS), Modified Rankin Scale (mRS) and Barthel Index (BI) were used to evaluate patients’ neurologic impairment, disability degree, life quality and treatment effective rate. Safety indexes included adverse events and life vital signs. Results NHISS scores of the trial group and the control group were respectively (7.46±1.99) and (7.20±2.47) points before the treatment, (5.81±2.30) and (5.54±2.58) points one week after the treatment, (3.93±2.40) and (3.79±2.39) points two weeks after the treatment, (1.85±1.63) and (2.08±2.01) points 12 weeks after the treatment. There was no significant difference between the two groups at all time points (P>0.05). BI and mRS grading were not significantly different between the two groups at all time points after the treatment (P>0.05). NHISS score, mRS grading and BI at each time point after the treatment were significantly different from those before the treatment (P<0.05). No significant differences were found between the two groups in the treatment effective rate at each time point (P>0.05). Fifty patients (41.66%) in the trial group had 111 adverse events (92.50%), and 61 (50.83%) in the control group had 145 adverse events (120.83%). There was no significant difference between the two groups (P>0.05). Moreover, most of the adverse reactions were at a mild degree. Life vital signs two weeks after the treatment were not significantly different between the two groups, either (P>0.05). Conclusion Imported oxiracetam injection is of similar efficacy and safety with domestic Oulantong injection in the treatment of acute cerebral infarction.