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    Home > Active Ingredient News > Study of Nervous System > Pay attention to the mental and behavioral symptoms of children with epilepsy, and rational drug selection is the key

    Pay attention to the mental and behavioral symptoms of children with epilepsy, and rational drug selection is the key

    • Last Update: 2021-04-14
    • Source: Internet
    • Author: User
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    *For medical professionals to read only for reference, lacosamide is re-approved, and it is also available for 4 years old and above! Epilepsy is one of the most common neurological diseases in children and adolescents.

    Generally speaking, short-term, infrequent seizures will not cause brain damage and other problems, but without reasonable and effective treatment, long-term, frequent or severe seizures will cause further brain damage and even permanent nerves.
    Mental disorders.

    Especially for young children in the growth and development period, an attack may be a brain injury, and even affect the child's intelligence.

    Data show that about 30% of epilepsy patients have cognitive deficits.

    Seizures can also cause some children with autism, low self-esteem, depression and other negative psychology.

    Seriously affect children's study and life.

    Therefore, when choosing antiepileptic drugs (AED), a new type of AED should be selected according to the type of seizures and other complications of the child, which can effectively control the seizures and has a relatively small impact on the mental behavior of the child.

    In the process of medication, attention should be paid to observe whether it affects the cognitive function of children.

    Different anti-epileptic drugs have very different effects on cognition and behavior.
    With the deepening of understanding of the pathogenesis of epilepsy, the continuous emergence of new clinical treatment technologies and methods, and the successive launch of new AEDs, the impact on cognition and behavior is also increasing.
    In the gradual improvement.

    ▌ The first-generation AED is often prone to negative effects.
    Table 1: The impact of the first-generation AED on the mental behavior of patients with epilepsy.
    PHT: phenytoin, PBT: phenobarbital; VPA: sodium valproate; CBZ: carbamazepine and phenytoin The first-generation AEDs represented by sodium, phenobarbital, sodium valproate and carbamazepine have mainly negative effects on patients' attention/behavior/cognition.▌ The second-generation AED has less mental impact on behavior, cognition, etc.
    Table 2: The impact of the second-generation AED on the mental behavior of patients with epilepsy GBP: gabapentin; TPM: topiramate; OXC: oxcarbazepine; LTG: lamer Triazine; LEV: Levetiracetam.

    In the second-generation AED, especially Levetiracetam has less mental impact on behavior and cognition.

    ▌ The third-generation AED lacosamide affects cognitive behavior small table 3: The third-generation AED affects the mental behavior of patients with epilepsy PER: Perampanel; LCM: Lacosamide third-generation AED affects cognitive behavior There has been a big improvement.

    Among them, lacosamide has little effect on cognitive behavior.

    The third-generation anti-epileptic drug, lacosamide, can effectively control epileptic seizures and significantly improve children's bad behavior.

    In January 2021, it was approved by the National Medical Products Administration (NMPA) for the monotherapy of partial seizures in patients with epilepsy 4 years and older.

    Lacosamide not only has a significant effect in suppressing epileptic seizures, but also significantly improves children's bad behaviors, providing a better choice for children with epilepsy.

    ▌ Lacosamide significantly improved the bad behaviors of children with epilepsy.
    A study included 79 patients with refractory focal epilepsy in children (mean age 8.
    84 ± 3.
    09 years), using lacosamide as an additive treatment, using Connor's behavior The rating scale evaluates the safety, tolerability and influence of lacosamide on behavior.

    The results showed that after 3 months of treatment, the patient's bad behavior was significantly improved [1].

    Figure 1: Lacosamide can effectively improve the Connor's Behavior Rating Scale score in children with epilepsy.
    Connor's Behavior Rating Scale: A total of 25 questions involving emotional distress, aggressive behavior, learning difficulties (language, mathematics and overall), hyperactivity, Impulsivity, social problems, fear of separation, perfectionism and compulsive behavior, violent tendencies, and physical symptoms.

    A high score indicates a poorer behavioral performance of the patient.

    The total score ranges from 10 points (indicating good behavior) to 75 points (indicating poor behavior)▌ Lacosamide significantly improves executive function and verbal memory.
    A study included 94 patients with epilepsy who used lacosamide (n = 37) or perampanel (n = 57) as an add-on therapy, the Epi-Track scale was used to evaluate executive function, the short version of the VLMT scale was used to evaluate verbal memory, and the median follow-up was 36 weeks to evaluate the long-term use of the above two drugs The effect on the cognitive function of patients with epilepsy, the results show that lacosamide significantly improves the executive function and verbal memory of patients [2].

    Figure 2: Lacosamide can effectively improve the treatment of epilepsy in children with Epi-Track scale and VLMT scale scores.
    It is necessary to pay attention to the effect of drugs on children's growth and development and mental behavior.

    Reasonable selection of drugs and standardized treatment are the key.

    Most children with epilepsy can control their seizures and even cure them through standardized treatment, and can grow up happily like other children.

    References: [1] Pasha I, et al.
    Saudi Pharm J.
    2015 Oct; 23(5): 556-61.
    [2] Meschede C, et al.
    Seizure.
    2018 May; 58: 141-146.
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