Epilepsy is a chronic episodic brain disorder with a high incidence and can seriously affect the quality of life of the patients. Therefore, timely treatment to control seizures is particularly important. Numerous studies have shown the effect of antiepileptic drugs on cognition, but there are few studies on the effects of different functional areas in children.

To explore the effects of sodium valproate (VPA) , oxcarbazepine (OXC) and levetiracetam (LEV) on the development of different functional areas in children with focal epilepsy by Griffiths Development Scales-Chinese Edition (GDS-C) .

A total of 83 children with focal epilepsy who attended in outpatient and ward of the Department of Pediatric Neurology of the Third Affiliated Hospital of Zhengzhou University for the first time from January 2021 to April 2022 were selected, and randomly divided into VPA group (n=27) , OXC group (n=28) and LEV group (n=28) according to the random number table method, 30 healthy children who were examined during the same period were selected as the control group. The changes of EEG interictal epileptiform activity (IEA) before and after 6 months of treatment were recorded and the clinical effect was evaluated according to seizure frequency, the GDS-C was used to evaluate the development quotient of each functional area in the children.

The total clinical effective rates of VPA group, OXC group and LEV group were 92.6%, 89.3% and 92.9%, with no significant difference among the three groups (χ²=0.418, P=1.000) . The total EEG IEA effective rate of the VPA group, OXC group and LEV group were 88.9%, 57.1% and 89.3%, with significant differences among the three groups (χ²=11.152, P=0.004) ; the total effective rate of EEG IEA in OXC group was lower than that in VPA group and LEV group (P<0.05) . Before treatment, there were statistically significant differences in the the development quotient of each dimension among four groups (P<0.05) ; the development quotient of each dimension in three groups were lower than that in the control group (P<0.05) . After treatment, there were significant differences in the the development quotients of hand-eye coordination and performance dimensions among three groups (P<0.05) ; the development quotients of sports and personal-social dimensions in LEV group were higher than VPA group (P<0.05) , the development quotients of personal-social, hand-eye coordination and performance dimensions in LEV group were higher than OXC group (P<0.05) . Compared to the pre-treatment period, the development quotients of personal-social and practical reasoning dimensions significantly decreased in VPA group (P<0.05) , the development quotients of personal-social, language, hand-eye coordination, performance and practical reasoning dimensions significantly increased (P<0.05) .

VPA, OXC and LEV are all effective in the treatment of focal epilepsy in children, and all three have quivalent efficacy; In terms of improving EEG IEA, OXC is inferior to VPA and LEV; VPA may have a negative effect on personal-social and practical reasoning dimensions, OXC has little effect, and LEV may have improvement on personal-social, language, hand-eye coordination, performance, practical reasoning dimensions.

癫痫是一种慢性发作性脑部疾病，发病率较高，可严重影响患者的生活质量。因此，及时治疗控制癫痫发作尤为重要。大量研究表明抗癫痫药物对认知有影响，但具体到对患儿不同能区的影响研究较少。

采用Griffiths精神发育评估量表中文版（GDS-C）探讨丙戊酸钠（VPA）、奥卡西平（OXC）、左乙拉西坦（LEV）对局灶性癫痫患儿不同能区发育的影响。

选取2021年1月—2022年4月在郑州大学第三附属医院小儿神经内科首次门诊及病房就诊的局灶性癫痫发作患儿83例，按随机数字表法将其分为VPA组27例、OXC组28例、LEV组28例，将同期体检的30名健康儿童作为对照组。依据发作频率评价临床疗效，记录治疗前及治疗6个月后脑电图癫痫样放电（IEA）变化情况，采用GDS-C对受试儿童不同能区的发育商进行评估。

VPA组、OXC组、LEV组患儿临床疗效总有效率分别为92.6%、89.3%、92.9%，三组比较差异无统计学意义（χ²=0.418，P=1.000）。VPA组、OXC组、LEV组患儿脑电图IEA情况总有效率分别为88.9%、57.1%、89.3%，三组比较差异有统计学意义（χ²=11.152，P=0.004）；其中OXC组患儿脑电图IEA情况总有效率低于VPA组和LEV组（P<0.05）。治疗前，四组受试儿童各维度发育商比较，差异均有统计学意义（P<0.05）；三组患儿各维度发育商均低于对照组（P<0.05）。治疗后，三组患儿手眼协调、表现维度发育商比较，差异有统计学意义（P<0.05）；LEV组患儿运动、个人-社会维度发育商高于VPA组（P<0.05）；LEV组患儿个人-社会、手眼协调、表现维度发育商高于OXC组（P<0.05）。与治疗前相比，VPA组患儿个人-社会、实际推理维度发育商均降低（P<0.05）；LEV组患儿个人-社会、语言、手眼协调、表现、实际推理维度发育商均升高（P<0.05）。

VPA、OXC、LEV对儿童局灶性癫痫均有较好的治疗作用，且三者疗效相当；脑电图IEA情况改善方面，OXC劣于VPA、LEV；VPA可能对患儿个人-社会、实际推理维度产生不利影响，OXC影响不大，LEV对患儿个人-社会、语言、手眼协调、表现、实际推理维度可能具有一定的改善作用。