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01-10-2021 | Antiepileptic Drugs | Original article

Effects of levetiracetam and oxcarbazepine monotherapy on intellectual and cognitive development in children with benign epilepsy with centrotemporal spikes

Authors: Gui-hai Suo, Yu-qin Zheng, You-jia Wu, Ji-hong Tang

Published in: Acta Neurologica Belgica | Issue 5/2021

Abstract

Levetiracetam (LEV) and oxcarbazepine (OXC) are commonly used in the treatment of epilepsy, but their efficacy and safety have seldom been compared for the treatment of children with benign epilepsy with centrotemporal spikes (BECTS). We thus assessed the efficacy of LEV and OXC monotherapy in the treatment of children with BECTS, and the effect of this treatment on children’s intelligence and cognitive development. This was a randomized, single-center trial. Children with BECTS were randomized (1:1) into LEV and OXC groups, and were assessed at 1, 3 and 6 months after treatment. The primary outcomes were the frequency of seizures and changes in intelligence and cognitive function. Secondary outcomes were electroencephalogram (EEG) results and safety. Seventy children were enrolled and randomized to the LEV group or the OXC group, and 32 of the 35 children in each group completed the study. After 6 months, the effective treatment rate of the OXC group was significantly higher than that of the LEV group (78.12 vs. 53.12%, p = 0.035). However, no significant inter-group difference was observed in EEG improvement (p = 0.211). In terms of intelligence and cognitive development, children in the OXC group exhibited significantly improved choice reaction time, mental rotation, and Wisconsin Card Sorting Test results (all p < 0.05). Both LEV and OXC were well tolerated, with 18.75 and 21.88% of children reporting mild adverse events (p = 0.756). OXC monotherapy was more effective than LEV for children with BECTS. In addition, children with OXC monotherapy had higher improvements in children’s intelligence and cognitive function than those with LEV monotherapy.

Sadr SS, Javanbakht J, Javidan AN, Ghaffarpour M, Khamse S, Naghshband Z (2018) Descriptive epidemiology: prevalence, incidence, sociodemographic factors, socioeconomic domains, and quality of life of epilepsy: an update and systematic review. Arch Med Sci 14(4):717–724. https://doi.org/10.5114/aoms.2016.60377CrossRefPubMed

Engel J Jr (2001) A proposed diagnostic scheme for people with epileptic seizures and with epilepsy: report of the ILAE task force on classification and terminology. Epilepsia 42(6):796–803. https://doi.org/10.1046/j.1528-1157.2001.10401.xCrossRefPubMed

Teixeira J, Santos ME (2018) Language skills in children with benign childhood epilepsy with centrotemporal spikes: a systematic review. Epilepsy Behav 84:15–21. https://doi.org/10.1016/j.yebeh.2018.04.002CrossRefPubMed

Miziara CS, Manreza ML (2010) Hemispheric lateralization in benign focal epilepsy in childhood with centrotemporal spikes (BECTS). Clin EEG Neurosci 41(3):147–150. https://doi.org/10.1177/155005941004100308CrossRefPubMed

Neumann H, Helmke F, Thiels C, Polster T, Selzer LM, Daseking M et al (2016) Cognitive development in children with benign Rolandic epilepsy of childhood with centrotemporal spikes—results of a current systematic database search. Fortschr Neurol Psychiatr 84(10):617–632. https://doi.org/10.1055/s-0042-115477CrossRefPubMed

Stefan H, Feuerstein TJ (2007) Novel anticonvulsant drugs. Pharmacol Ther 113(1):165–183. https://doi.org/10.1016/j.pharmthera.2006.07.005CrossRefPubMed

Furwentsches A, Bussmann C, Ramantani G, Ebinger F, Philippi H, Poschl J et al (2010) Levetiracetam in the treatment of neonatal seizures: a pilot study. Seizure 19(3):185–189. https://doi.org/10.1016/j.seizure.2010.01.003CrossRefPubMed

Donati F, Gobbi G, Campistol J, Rapatz G, Daehler M, Sturm Y et al (2007) The cognitive effects of oxcarbazepine versus carbamazepine or valproate in newly diagnosed children with partial seizures. Seizure 16(8):670–679. https://doi.org/10.1016/j.seizure.2007.05.006CrossRefPubMed

Verrotti A, Parisi P, Loiacono G, Mohn A, Grosso S, Balestri P et al (2009) Levetiracetam monotherapy for childhood occipital epilepsy of gastaut. Acta Neurol Scand 120(5):342–346. https://doi.org/10.1111/j.1600-0404.2009.01264.xCrossRefPubMed

10.

Bresnahan R, Atim-Oluk M, Marson AG (2020) Oxcarbazepine add-on for drug-resistant focal epilepsy. Cochrane Database Syst Rev 3(3):CD012433. https://doi.org/10.1002/14651858.CD012433.pub2

11.

Marson AG, Al-Kharusi AM, Alwaidh M, Appleton R, Baker GA, Chadwick DW et al (2007) The SANAD study of effectiveness of carbamazepine, gabapentin, lamotrigine, oxcarbazepine, or topiramate for treatment of partial epilepsy: an unblinded randomised controlled trial. Lancet 369(9566):1000–1015. https://doi.org/10.1016/S0140-6736(07)60460-7CrossRefPubMedPubMedCentral

12.

Kim JH, Lee SK, Loesch C, Namgoong K, Lee HW, Hong SB (2017) Comparison of levetiracetam and oxcarbazepine monotherapy among Korean patients with newly diagnosed focal epilepsy: a long-term, randomized, open-label trial. Epilepsia 58(4):e70–e74. https://doi.org/10.1111/epi.13707CrossRefPubMed

13.

Fisher RS (2017) The new classification of seizures by the international league against epilepsy 2017. Curr Neurol Neurosci Rep 17(6):48. https://doi.org/10.1007/s11910-017-0758-6CrossRefPubMed

14.

Crepeau AZ, Treiman DM (2010) Levetiracetam: a comprehensive review. Expert Rev Neurother 10(2):159–171. https://doi.org/10.1586/ern.10.5CrossRefPubMed

15.

Rating D, Wolf C, Bast T (2000) Sulthiame as monotherapy in children with benign childhood epilepsy with centrotemporal spikes: a 6-month randomized, double-blind, placebo-controlled study. Sulthiame Study Group. Epilepsia 41(10):1284–1288. https://doi.org/10.1111/j.1528-1157.2000.tb04606.xCrossRefPubMed

16.

Liu MJ, Su XJ, Shi XY, Wu GF, Zhang YQ, Gao L et al (2017) Clinical features of benign epilepsy of childhood with centrotemporal spikes in Chinese children. Medicine (Baltimore) 96(4):e5623. https://doi.org/10.1097/MD.0000000000005623CrossRef

17.

Du Y, Lin J, Shen J, Ding S, Ye M, Wang L et al (2019) Adverse drug reactions associated with six commonly used antiepileptic drugs in southern China from 2003 to 2015. BMC Pharmacol Toxicol 20(1):7. https://doi.org/10.1186/s40360-019-0285-yCrossRefPubMedPubMedCentral

18.

Giustizieri M, Armogida M, Berretta N, Federici M, Piccirilli S, Mercuri NB et al (2008) Differential effect of carbamazepine and oxcarbazepine on excitatory synaptic transmission in rat hippocampus. Synapse 62(10):783–789. https://doi.org/10.1002/syn.20556CrossRefPubMed

19.

Bertsche A, Neininger MP, Dahse AJ, Syrbe S, Bernhard MK, Frontini R et al (2014) Initial anticonvulsant monotherapy in routine care of children and adolescents: levetiracetam fails more frequently than valproate and oxcarbazepine due to a lack of effectiveness. Eur J Pediatr 173(1):87–92. https://doi.org/10.1007/s00431-013-2125-1CrossRefPubMed

20.

Thelengana A, Shukla G, Srivastava A, Singh MB, Gupta A, Rajan R et al (2019) Cognitive, behavioural and sleep-related adverse effects on introduction of levetiracetam versus oxcarbazepine for epilepsy. Epilepsy Res 150:58–65. https://doi.org/10.1016/j.eplepsyres.2019.01.004CrossRefPubMed

21.

Liu WT, Yan XX, Cheng DZ, Zhang HZ, Ding N, Xu KM et al (2020) Oxcarbazepine monotherapy in children with benign epilepsy with centrotemporal spikes improves quality of life. Chin Med J (Engl) 133(14):1649–1654. https://doi.org/10.1097/CM9.0000000000000925CrossRef

22.

Goldberg-Stern H, Feldman L, Eidlitz-Markus T, Kramer U, Perez S, Pollak L et al (2013) Levetiracetam in children, adolescents and young adults with intractable epilepsy: efficacy, tolerability and effect on electroencephalogram–a pilot study. Eur J Paediatr Neurol 17(3):248–253. https://doi.org/10.1016/j.ejpn.2012.10.008CrossRefPubMed

23.

Vendrame M, Khurana DS, Cruz M, Melvin J, Valencia I, Legido A et al (2007) Aggravation of seizures and/or EEG features in children treated with oxcarbazepine monotherapy. Epilepsia 48(11):2116–2120. https://doi.org/10.1111/j.1528-1167.2007.01210.xCrossRefPubMed

24.

Perucca E (2005) Pharmacokinetic variability of new antiepileptic drugs at different ages. Ther Drug Monit 27(6):714–717. https://doi.org/10.1097/01.ftd.0000179847.37965.4eCrossRefPubMed

25.

Kothare SV, Khurana DS, Mostofi N, Melvin JJ, Marks HG, Valencia I et al (2006) Oxcarbazepine monotherapy in children and adolescents: a single-center clinical experience. Pediatr Neurol 35(4):235–239. https://doi.org/10.1016/j.pediatrneurol.2006.02.009CrossRefPubMed

26.

Schmidt D, Sachdeo R (2000) Oxcarbazepine for treatment of partial epilepsy: a review and recommendations for clinical use. Epilepsy Behav 1(6):396–405. https://doi.org/10.1006/ebeh.2000.0126CrossRefPubMed

Title: Effects of levetiracetam and oxcarbazepine monotherapy on intellectual and cognitive development in children with benign epilepsy with centrotemporal spikes
Authors: Gui-hai Suo
Yu-qin Zheng
You-jia Wu
Ji-hong Tang
Publication date: 01-10-2021
Publisher: Springer International Publishing
Keywords: Antiepileptic Drugs
Epilepsy
Antiepileptic Drugs
Levetiracetam
Oxcarbazepine
Published in: Acta Neurologica Belgica / Issue 5/2021
Print ISSN: 0300-9009
Electronic ISSN: 2240-2993
DOI: https://doi.org/10.1007/s13760-021-01613-5

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Effects of levetiracetam and oxcarbazepine monotherapy on intellectual and cognitive development in children with benign epilepsy with centrotemporal spikes

Abstract

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