Clinical study of the effect of 5 kinds of antiepileptic drugs on the postictal state

• Published in: Epilepsy & behavior Vol. 158; p. 109897
• Main Authors: Cao, Lanlan, Chen, Yue, Lv, Ning, Xu, Yanchi, Chen, Honghua, Tao, Lihong
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.09.2024
• Subjects: Adolescent; Adult; Anticonvulsants - therapeutic use; Antiepileptic drugs; Electroencephalography; Epilepsy; Epilepsy - drug therapy; Female; Humans; Lamotrigine - therapeutic use; Levetiracetam - therapeutic use; Male; Middle Aged; Oxcarbazepine - pharmacology; Oxcarbazepine - therapeutic use; Postictal State; Severity of Illness Index; Treatment; Treatment Outcome; Valproic Acid - therapeutic use; Young Adult; Treatment; Postictal State; Antiepileptic drugs; Epilepsy
• ISSN: 1525-5050; 1525-5069; 1525-5069
• DOI: 10.1016/j.yebeh.2024.109897

•The manifestations of post seizure states are diverse.•Evaluate the post seizure status of patients using LSSS2.0, SSQ, and GTE scales.•Levetiracetam, lamotrigine, oxcarbazepine, topiramate, and valproate demonstrate favorable efficacy in ameliorating the severity of postictal state. To compare the effects of levetiracetam（LEV）, lamotrigine(LTG), oxcarbazepine(OXC), topiramate(TPM) and valproate (VPA) on postictal state (PIS). A total of 187 epilepsy patients undergoing monotherapy were enrolled in a long-term follow-up study at the Affiliated Hospital of Yangzhou College. This included 30 patients on levetiracetam, 41 on valproate, 30 on oxcarbazepine, 28 on topiramate, and 31 on lamotrigine. A control group of 28 newly diagnosed or previously untreated epilepsy patients was also included. The Liverpool Seizure Severity Scale 2.0 (LSSS2.0) and the Seizure Severity Questionnaire (SSQ) were utilized to evaluate the patients’ condition, with comparison based on the results of the postictal status items. EEG during PIS termination was assessed using the Grand Total EEG score (GTE) as an objective tool to measure the impact of Antiseizure medications (ASMs) on the post-seizure state. The LSSS2.0 score indicated a statistically significant difference in post-seizure status score among the 5 groups (p < 0.05). The difference between the 5 groups and the control group was statistically significant (p < 0.05). Results of the SSQ demonstrated that all 5 drugs significantly reduced the post-seizure status score compared to the control group (p < 0.05). The GTE score revealed that, in the later stage of the seizure, the GTE score of the levetiracetam group, valproate group, oxcarbazepine group, and lamotrigine group significantly decreased compared to the control group (P < 0.05). There was no significant decrease in the GTE score in the topiramate group (P < 0.05). Levetiracetam, lamotrigine, oxcarbazepine, topiramate, and valproate demonstrate favorable efficacy in ameliorating the severity of post-seizure condition. Further investigations are warranted to assess the potential of other widely employed anti-seizure medications in enhancing post-seizure status.