Efficacy and sleep impact of perampanel versus levetiracetam monotherapy for SeLECTS: A pilot prospective cohort study
Abstract
OBJECTIVE
Self-limited epilepsy with centrotemporal spikes (SeLECTS) is one of the most common childhood epilepsy syndromes. Its epileptiform discharges are closely linked to sleep, making sleep evaluation particularly important in its management. This study compared the effects of levetiracetam (LEV) and perampanel (PER) on seizure control and sleep outcomes to provide evidence for individualized treatment strategies in children with SeLECTS.
METHODS
Thirty-five children with SeLECTS (aged 6-12 years) receiving monotherapy (PER, n = 19; LEV, n = 16) were enrolled and followed for at least 3 months. Clinical characteristics, seizure frequency, and adverse drug reactions were recorded. Electroencephalography (EEG) assessed epileptiform discharges and the spike-wave index (SWI). The Children's Sleep Habits Questionnaire (CSHQ) and the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD) evaluated subjective sleep quality and daytime sleepiness, respectively. Polysomnography (PSG) measured objective sleep parameters: sleep efficiency (SE), sleep architecture, sleep latency (SL), wake time after sleep onset (WASO), and number of awakenings (NAW). The Wechsler Intelligence Scale for Children-Fourth Edition (WISC-IV) and the Quality of Life in Children with Epilepsy Questionnaire-16 (QOLCE-16) assessed intelligence development and quality of life, respectively.
RESULTS
The median follow-up duration was 144.5 days (96.0, 209.5) in LEV group and 128.0 days (102.0, 196.0)…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 19 participants or records.
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