Original Article

Comparison of the Therapeutic Effects of Sodium Valproate and Levetiracetam on Pediatric Epilepsy and the Effects of Nerve Growth Factor and γ-Aminobutyric Acid


Background: We aimed to investigate the therapeutic effect of sodium valproate combined with levetiracetam on pediatric epilepsy and the effects of nerve growth factor and γ-aminobutyric acid.

Methods: Eighty-three epileptic children admitted to Xuzhou Municipal Hospital of Xuzhou Medical University (Xuzhou, China) from Jan 2018 to Nov 2019 were collected and divided into a control group (40 cases, treated with sodium valproate alone) and an observation group (43 cases, treated with sodium valproate combined with levetiracetam). The therapeutic effect and incidence of adverse reactions were observed. The levels of nerve growth factor (NGF), γ-aminobutyric acid (GABA) and serum neuron-specific enolase (NSE) of children were compared. Changes of cognitive function and the total effective rate were evaluated. Logistic regression analysis was used to analyze the risk factors affecting the therapeutic effect.

Results: After treatment, NGF, GABA and NSE in the observation group were significantly improved compared with those before treatment. The cognitive function of the observation group was significantly improved after treatment when compared with the control group. The total effective rate in the observation group was higher than that in the control group. Adverse reactions in the observation group were less than those in the control group. Seizure type, NGF, GABA, NSE and treatment methods were independent risk factors affecting the therapeutic effect of pediatric epilepsy.

Conclusion: The application of sodium valproate combined with levetiracetam in the treatment of pediatric epilepsy is helpful to improve the overall therapeutic effect, significantly improve the cognitive function of children, and improve the levels of NGF, GABA and NSE.

1. Omran A, Dalia E, Fei Y (2013). Mi-croRNAs: new insights into chronic childhood diseases. BioMed Res Int, 2013: 291826.
2. Korsholm K, Ian L (2013). Effects of a ke-togenic diet on brain metabolism in epi-lepsy. Clin Nucl Med, 38 (1): 38-9.
3. Kumkamthornkul P, Udnaen S, Tansit T, et al (2018). Evaluation of a lymphocyte transformation test and cytokine detec-tion assay to identify phenytoin and car-bamazepine provoked DRESS or SJS/TEN in epilepsy patients. Int Im-munopharmacol, 63: 204-210.
4. Hauser W A (1995). Epidemiology of epi-lepsy in children. Neurosurg Clin N Am, 4 6(3):419-29.
5. Dwivedi R, Ramanujam B, Chandra P S, et al (2017). Surgery for drug-resistant epi-lepsy in children. N Engl J Med, 377: 1639-1647.
6. Lin SF, Lin TC, Hu HH, et al (2015). Bilat-eral paramedian thalamic infarction pre-senting as status epilepticus: a case report and review of the literatures. Acta Neurol Taiwan, 24(4):125-30.
7. Perucca P, Scheffer I E, Kiley M (2018). The management of epilepsy in children and adults. Med J Aust, 208(5):226-233.
8. Bialer M, Johannessen SI, Levy RH, et al (2017). Progress report on new antiepi-leptic drugs: a summary of the Thirteenth Eilat Conference on New Antiepileptic Drugs and Devices (EILAT XIII). Epilep-sia, 58(2):181-221.
9. Toledo M, Beale R, Evans JS, et al (2017). Long-term retention rates for antiepilep-tic drugs: A review of long-term exten-sion studies and comparison with briva-racetam. Epilepsy Res, 138: 53-61.
10. Guerrini R (2012). Principles of Treatment of Epilepsy in Children and Adolescents. Epilepsy and Epileptic Seizures, 187: 186-194.
11. Sunwoo JS, Park BS, Ahn SJ, et al (2017). Three-year retention rates of levetirace-tam, topiramate, and oxcarbazepine: a ret-rospective hospital-based study. Clin Neu-ropharmacol, 40(2):56-62.
12. Romoli M, Mazzocchetti P, D'Alonzo R, et al (2019). Valproic acid and epilepsy: from molecular mechanisms to clinical evidences. Curr Neuropharmacol, 17(10):926-946.
13. Thelengana A, Shukla G, Srivastava A, et al (2019). Cognitive, behavioural and sleep-related adverse effects on introduction of levetiracetam versus oxcarbazepine for epilepsy. Epilepsy Res, 150: 58-65.
14. Habib M, Khan SU, Hoque A, et al (2013). Antiepileptic drug utilization in Bangla-desh: experience from Dhaka Medical College Hospital. BMC Res Notes, 6: 473.
15. Auvin S (2016). Advancing pharmacologic treatment options for pharmacologic treatment options for children with epi-lepsy. Expert Opin Pharmacother, 17 (11): 1475–82.
16. Arzimanoglou A, O’Neill DC, Nordli D, et al (2018). A review of the new antiepilep-tic drugs for focal-onset seizures in pedi-atrics: role of extrapolation. Pediatric Drugs, 20(3):249-264.
17. Bosak M, Słowik A, Iwańska A, et al (2019). Co-medication and potential drug inter-actions among patients with epilepsy. Sei-zure, 66: 47-52.
18. Scheffer I E, Berkovic S, Capovilla G, et al (2017). ILAE classification of the epilep-sies: position paper of the ILAE Com-mission for Classification and Terminol-ogy. Epilepsia, 58(4):512-521.
19. Holland KD, Monahan S, Morita D, et al (2010). Valproate in children with newly diagnosed idiopathic generalized epilepsy. Acta Neurol Scand, 121(3): 149–153.
20. Drijvers JM, Awan IM, Perugino CA, et al (2017). The Enzyme-Linked Immuno-sorbent Assay: The Application of ELI-SA in Clinical Research. Basic Science Methods for Clinical Researchers. Basic Science Methods for Clinical Researchers, 2017: 119-133.
21. Sherman EM, Wiebe S, Fay-McClymont TB, et al (2011). Neuropsychological out-comes after epilepsy surgery: systematic review and pooled estimates. Epilepsia, 52(5):857-69.
22. Hanci F, Canpolat M, Per H, et al (2019). The relation between antiepileptic drug type and cognitive functions in childhood epilepsy: a prospective observational study. Experimental Biomedical Research, 2(2): 62-68.
23. Moavero R, Pisani LR, Pisani F, et al (2018). Safety and tolerability profile of new an-tiepileptic drug treatment in children with epilepsy. Expert Opin Drug Saf, 17:(10) 1015-1028.
24. Alsfouk BAA (2018). Long-term efficacy and tolerability of antiepileptic drugs in newly diagnosed epilepsy patients. Uni-versity of Glasgow, 9104: 1-231.
25. Moosa ANV (2019). Antiepileptic drug treatment of epilepsy in children. Continu-um (Minneap Minn), 25(2):381-407.
26. Baker GA, Bromley RL, Briggs M, et al (2015). IQ at 6 years after in utero expo-sure to antiepileptic drugs: a controlled cohort study. Neurology, 84(4): 382–390.
27. Balagura G, Iapadre G, Verrotti A, et al (2019). Moving beyond sodium valproate: choosing the right anti-epileptic drug in children. Expert Opin Pharmacother, 20(12):1449-1456.
28. Muramatsu K, Sawaura N, Ogata T, et al (2017). Efficacy and tolerability of le-vetiracetam for pediatric refractory epilep-sy. Brain Dev, 39(3):231-235.
29. Cortes-Altamirano JL, Olmos-Hernández A, Bonilla-Jaime H, et al (2016). Levetirace-tam as an antiepileptic, neuroprotective, and hyperalgesic drug. Neurol India, 64(6):1266-1275.
30. Zhao J, Sang Y, Zhang Y, et al (2019). Effi-cacy of levetiracetam combined with so-dium valproate on pediatric epilepsy and its effect on serum miR-106b in children. Exp Ther Med, 18(6): 4436-4442.
31. Weijenberg A, Brouwer OF, Callenbach PM (2015). Levetiracetam Monotherapy in Children with Epilepsy: A Systematic Re-view. CNS Drugs, 29(5): 371–82.
32. Oh A, Thurman D J, Kim H (2017). Comorbidities and risk factors associated with newly diagnosed epilepsy in the US pediatric population. Epilepsy Behav, 75: 230-236.
33. Xiong TQ, Chen LM, Tan BH, et al (2018). The effects of calcineurin inhibitor FK506 on actin cytoskeleton, neuronal survival and glial reactions after pilocar-pine-induced status epilepticus in mice. Epilepsy Research, 140: 138-147.
34. Yang J, Yang B, Xiu B, et al (2018). Effect of combination therapy with neuropro-tective and vasoprotective agents on cer-ebral ischemia. Can J Neurol Sci, 45(3):325-331.
35. Sun W L, Quizon P M, Zhu J (2016). Mo-lecular mechanism: ERK signaling, drug addiction, and behavioral effects. Prog Mol Biol Transl Sci, 137: 1-40.
36. Shi L, Chen R, Zhang H, et al (2017). Cere-brospinal fluid neuron specific enolase, interleukin-1β and erythropoietin concen-trations in children after seizures. Childs Nerv Syst, 33(5): 805-811.
IssueVol 50 No 3 (2021) QRcode
SectionOriginal Article(s)
DOI https://doi.org/10.18502/ijph.v50i3.5593
Pediatric epilepsy Sodium valproate Levetiracetam Nerve growth factor γ-aminobutyric acid

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
CHEN M, JIANG Y, MA L, ZHOU X, WANG N. Comparison of the Therapeutic Effects of Sodium Valproate and Levetiracetam on Pediatric Epilepsy and the Effects of Nerve Growth Factor and γ-Aminobutyric Acid. Iran J Public Health. 50(3):520-530.