Table1_Effectiveness of perampanel in the treatment of pediatric patients with focal epilepsy and ESES: A single-center retrospective study.DOCX

Objective: To investigate the therapeutic effect and influencing factors of perampanel (PER) on electrical status epilepticus during sleep (ESES).Methods: We retrospectively analyzed the clinical data of pediatric patients with focal epilepsy and ESES who were treated at the Epilepsy Center of Shengjing Hospital of China Medical University between January 2016 and March 2022. Changes in the spike wave index (SWI) after 24 weeks of PER add-on treatment were compared. Kaplan‒Meier survival analysis, the log-rank test and multivariate Cox regression analysis were performed.Results: A total of 54 pediatric patients met the inclusion criteria, including 33 males and 21 females. The mean age at the diagnosis of epilepsy was 6.41 ± 2.14 years and at ESES diagnosis was 7.58 ± 2.40 years. The mean ESES duration before add-on PER was 25.31 ± 15.12 months. The mean age of the patients at add-on PER initiation was 9.69 ± 2.12 years. The ESES resolved in 29 children after 6 months of PER add-on treatment, and the response rate was 53.7%. Univariate analysis with the log-rank test showed that the therapeutic effect of PER differed according to the age at ESES diagnosis and ESES duration before add-on PER treatment. Multivariate Cox regression analysis showed that only ESES duration before PER administration was a risk factor for PER treatment failure, and the other factors had no effect on the therapeutic effect.Conclusion: PER add-on treatment has a good therapeutic effect on ESES and can be used as an alternative to corticosteroid and benzodiazepines. The therapeutic effect of PER add-on treatment was not related to the dose. A longer ESES duration results in a worse therapeutic effect. Therefore, more aggressive treatment measures should be implemented for ESES.

研究目的：探讨丙戊酸（PER）对睡眠中癫痫发作（ESES）的治疗效果及其影响因素。研究方法：我们回顾性分析了2016年1月至2022年3月期间在沈阳中国医科大学附属盛京医院癫痫中心接受治疗的儿童局灶性癫痫及ESES患者的临床数据。比较了24周PER辅助治疗后棘波指数（SWI）的变化。采用Kaplan-Meier生存分析、Log-rank检验和多元Cox回归分析。研究结果：共有54名儿童患者符合纳入标准，包括33名男性和21名女性。癫痫诊断的平均年龄为6.41±2.14岁，ESES诊断的平均年龄为7.58±2.40岁。辅助PER前ESES的平均病程为25.31±15.12个月。患者开始辅助PER治疗时的平均年龄为9.69±2.12岁。在6个月PER辅助治疗后，29名儿童的ESES得到缓解，缓解率为53.7%。单因素分析中的Log-rank检验显示，PER的治疗效果根据ESES诊断时的年龄和辅助PER治疗前ESES的病程而有所不同。多元Cox回归分析显示，仅辅助PER前ESES的病程是治疗失败的风险因素，其他因素对治疗效果无影响。研究结论：PER辅助治疗对ESES具有良好的治疗效果，可作为皮质类固醇和苯二氮卓类药物的替代疗法。PER辅助治疗的治疗效果与剂量无关。ESES病程越长，治疗效果越差。因此，应采取更积极的治疗措施以应对ESES。