Abstract: Background　A large number of studies have proved that levetiracetam（LEV）is safe and effective in the control of partial seizures in children，but studies in improving the number of electroencephalogram（EEG）discharge quantity，background activity and cognition are incomprehensive.In addition，there are few reports on the association between EEG electrophysiology and cognitive function.Objective　To discuss the changes of clinical effect，the number of EEG discharge quantity，brainwave relative power and intelligence test of LEV monotherapy in partial seizures，and analyze the association of EEG result with the intelligence test and cognitive function.Methods　A total of 100 children with partial seizures diagnosed and treated in outpatient and ward of Children's Hospital of Hebei Province were selected from December 2014 to December 2017.The children were divided into control group and observation group by random number table method，each with 50 cases.The control group were given oxcarbazepine（OXC）orally，and the observation group were given LEV orally.Before and 3-6 months after treatment，the two groups were monitored EEG，recorded interictal epileptiform activity（IEA），and calculated the δ-band，θ-band，α-band，β-band brainwave relative power and discharge index.Verbal intelligence quotient （VIQ），performance intelligence quotient（PIQ）and full intelligence quotient（FIQ）were tested by Wechsler Intelligence Scale for Children（WISC）．Subsequently we evaluated the clinical effect before and after the treatment according to seizure frequency，evaluated EEG according to IEA after treatment，and classified intelligence level according to FIQ.Results　The total effective rate of the control group was 86.0%（43/50），and of the observation group was 82.0%（41/50）．There was no statistically significant difference in total effective rate between the two groups（χ2=0.128，P=0.720）．The total EEG effective rate of the observation group was 78.0%（39/50），which was higher than that of the control group of 52.0%（26/50）（χ2=7.429，P=0.006）．After the treatment，the δ-band and θ-band relative power in the observation group was lower than those in the control group，and its β-band relative power was higher than that in the control group（P<0.05）．δ-band andθ-band relative power in both groups after the treatment was lower than that before the treatment，and α-band relative power was higher than that before the treatment（P<0.05）；the β-band relative power in the control group after the treatment was lower than that before the treatment（P<0.05）；the β-band relative power in the observation group after treatment was higher than that before the treatment（P<0.05）．The VIQ，PIQ and FIQ were significantly higher in the observation group than those in control group after the treatment（P<0.05）．The VIQ，PIQ and FIQ were significantly higher after the treatment than those before the treatment in both groups（P<0.05）．The FIQ of observation group was negatively correlated with EEG discharge index（r=-0.286，
P<0.05），the ΔFIQ was positively correlated with the Δα-band and Δβ-band relative power（r=0.285，P<0.05；r=0.296，P<0.05）．Conclusion　Monotherapy of LEV is effective in the treatment of all types of partial seizures in children.In addition，the results were significant in improving the number of EEG discharges，background activity and cognition，and the changes in neuro-physiological parameters in epileptic children may be associated with improved cognitive function.

Key words: Epilepsies, partial；Oxcarbazepine；Levetiracetam；Epileptiform discharge；Electroencephalogram；Cognitive function

摘要： 背景　大量研究证明左乙拉西坦（LEV）控制儿童部分性癫痫发作是安全有效的，但在改善脑电图（EEG）放电数量、背景活动和认知方面的研究不全面，另外关于EEG生理与认知功能方面的研究报道甚少。目的　探讨LEV单药治疗部分性癫痫发作的临床疗效、EEG放电数量、脑电波相对功率改变和智力测试，并分析脑电波相对功率改变、智力测试与认知功能的联系。方法　选取2014年12月—2017年12月河北省儿童医院门诊和病房诊治的部分性癫痫患儿100例，采用随机数字表法将其分成对照组和观察组，各50例。对照组给予奥卡西平（OXC）口服治疗，观察组给予LEV口服治疗。于治疗前和治疗后3~6个月监测患儿EEG，记录患者治疗前后EEG发作间期癫痫样放电（IEA），计算δ、θ、α、β波段脑电波相对功率以及EEG放电指数，采用韦氏儿童智力测试量表（WISC）测试语言智商（VIQ）、操作智商（PIQ）和总智商（FIQ），依据发作频率评价临床治疗效果，依据治疗后IEA情况评价EEG，依据FIQ划分智力等级。结果　对照组总临床有效率为86.0%（43/50），观察组总临床有效率为82.0%（41/50）。两组总临床有效率比较，差异无统计学意义（χ2=0.128，P=0.720）。观察组总EEG有效率为78.0%（39/50），高于对照组的52.0%（26/50）（χ2=7.429，P=0.006）。治疗后观察组δ、θ波段相对功率低于对照组，β波段相对功率高于对照组（P<0.05）。两组患儿治疗后δ、θ波段相对功率均低于治疗前，α波段相对功率均高于治疗前（P<0.05）；对照组患儿治疗后β波段相对功率低于治疗前（P<0.05）；观察组治疗后β波段相对功率高于治疗前（P<0.05）。治疗后观察组患儿VIQ、PIQ、FIQ均高于对照组（P<0.05）。两组患儿治疗后VIQ、PIQ、FIQ均高于治疗前（P<0.05）。观察组FIQ与EEG放电指数呈负相关（r=-0.286，P<0.05），ΔFIQ与Δα波段相对功率、Δβ波段相对功率均呈正相关（r=0.285，P<0.05；r=0.296，P<0.05）。结论　LEV单药治疗儿童各类型部分性癫痫发作均有效，在改善EEG放电数量、背景活动和认知方面疗效显著，部分性癫痫患儿神经电生理指标改变与认知功能改善相关。

关键词: 癫痫, 部分性；奥卡西平；左乙拉西坦；癫痫样放电；脑电图；认知功能