Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Sep;20(3):2698-2704.
doi: 10.3892/etm.2020.8984. Epub 2020 Jul 10.

Efficacy and safety of sodium valproate plus lamotrigine in children with refractory epilepsy

Dongli Zhang  1 , Li Qiu  1 , Yuan Zhang  1 , Yan Sang  1 , Nuo Zheng  1 , Xiaoming Liu  1
Affiliations

Efficacy and safety of sodium valproate plus lamotrigine in children with refractory epilepsy

Dongli Zhang et al. Exp Ther Med. 2020 Sep.

Abstract

Efficacy and safety of sodium valproate (SV) and lamotrigine (LTG) in treating refractory epilepsy (RE) in children and the predictive value of serum neuron-specific enolase (NSE) and central nervous system specific S100β protein (S100β) on efficacy assessment were explored. A total of 110 RE children admitted to Xuzhou Children's Hospital, Xuzhou Medical University were enrolled. Patients treated with SV alone served as the control group (n=51), and those treated with SV plus LTG as the study group (n=59). Serum NSE and S100β expression levels were measured by enzyme-linked immunosorbent assay (ELISA). The efficacy, seizure frequency, adverse reactions, concentration of serum brain derived neurotrophic factor (BDNF) and nerve growth factor (NGF), and expression of serum NSE and S100β were observed and compared. The total effective rate in the study group was significantly higher than that in the control group, and the seizure frequency and incidence of adverse reactions were significantly lower than that in the control group. The study group showed remarkably higher BDNF and NGF than the control group after treatment. The expression of serum NSE and S100β in effectively treated children were significantly lower than that in ineffectively treated children. The area under the curve (AUC) of serum NSE and S100β were 0.828 and 0.814 respectively. SV combined with LTG is better and safer than SV alone in the treatment of RE in children. Serum NSE and S100β are of high value in predicting the efficacy.

Keywords: NSE; S100β; lamotrigine; refractory epilepsy; sodium valproate.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Comparison of neurotrophic indexes. (A) Comparison of BDNF before and after treatment. (B) Comparison of NGF before and after treatment. ***P<0.001. BDNF, brain derived neurotrophic factor; NGF, nerve growth factor.
Figure 2
Figure 2
Expression of serum NSE and S100β. (A) The expression of serum NSE in effectively treated children was significantly lower than that in ineffectively treated children. (B) The expression of serum S100β in effectively treated children was significantly lower than that in ineffectively treated children. ***P<0.001. NSE, neuron-specific enolase. S100β, specific S100β protein.
Figure 3
Figure 3
ROC curve of serum NSE and S100β in assessing efficacy. (A) ROC curve of serum NSE in assessing efficacy. (B) ROC curve of serum S100β in assessing efficacy. ROC, receiver operating characteristic; NSE, neuron-specific enolase. S100β, specific S100β protein.
See this image and copyright information in PMC

References

    1. Armeno M, Verini A, Del Pino M, Araujo MB, Mestre G, Reyes G, Caraballo RH. A prospective study on changes in nutritional status and growth following two years of ketogenic diet (KD) therapy in children with refractory epilepsy. Nutrients. 2019;11(1596) doi: 10.3390/nu11071596. - DOI - PMC - PubMed
    1. McGovern RA, Banks GP, McKhann GM. Responsive stimulation in the management of medically refractory epilepsy. In: Epilepsy Surgery and Intrinsic Brain Tumor Surgery. Fountas K and Kapsalaki E (eds). Springer, Cham, pp205-211, 2019.
    1. Sirven JI, Pedley TA, Wilterdink JL. Evaluation and management of drug-resistant epilepsy. UpToDate. https://www.uptodate.com/contents/evaluation-and-management-of-drug-resi.... Accessed August 13, 2018.
    1. Mishra S. Refractory epilepsy in children: A short review. South Asian Res J Med Sci. 2019;1:24–29.
    1. Nigro SE. The efficacy of neurofeedback for pediatric epilepsy. Appl Psychophysiol Biofeedback. 2019;44:285–290. doi: 10.1007/s10484-019-09446-y. - DOI - PubMed

LinkOut - more resources