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| Effect of Lamotrigine combined with cerebral hemispheric ring insular lobe transection in patients with valproic acid ineffective epilepsy |
| LI Chouzhong1 WEI Ling2 YUAN Baowen3▲ HU Xiao4 |
1.Department of Neurosurgery, Guizhou Provincial People’s Hospital, Guizhou Province, Guiyang 550000, China;
2.Department of Accupuncture, the First People’s Hospital of Bijie City, Guizhou Province, Guiyang 551700, China;
3.Department of Neurology, Guizhou Orthopedics Hospital, Guizhou Province, Guiyang 550000, China;
4.Department of Neurology, Guizhou Provincial People’s Hospital, Guizhou Province, Guiyang 550000, China |
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Abstract Objective To observe the effect of Lamotrigine combined with cerebral hemisphere ring insular lobe transection in the treatment of patients with valproic acid ineffective epilepsy. Methods A total of 86 patients with valproic acid ineffective epilepsy who were diagnosed and treated at Guizhou Provincial People’s Hospital from January 2017 to June 2018 were selected as the research objects. A total of 43 patients with valproic acid ineffective epilepsy who received Lamotrigine treatment were divided into the drug addition group, and another 43 patients with valproic acid ineffective epilepsy who received Lamotrigine addition combined with cerebral hemisphere ring lobe insula transection were divided into the Lamotrigine disconnection group. The effective rate of treatment, Wechsler intelligence scale for children (WISC) scores, hippocampal hydrogen ion magnetic resonance spectroscopy imaging parameters and adverse reactions were compared between the two groups. Results The effective rate of treatment in the Lamotrigine disconnection group was higher than that of the drug addition group, and the difference was statistically significant (P ＜ 0.05). The WISC scores of the two groups after treatment were higher than those before treatment, and the lamotrigine group was higher than that in the drug addition group, and the differences were statistically significant (P ＜ 0.05). After treatment, N-acetylaspartate acid (NAA) and NAA/(choline[Cho]+creatine[Cr]) of the two groups were higher than before treatment, while Cho and Cr were lower than before treatment, and NAA and NAA/(Cho+Cr) in the Lamotrigine dicconnection group were higher than those in the drug addition group, Cho, Cr were lower than those in the drug addition group, and the differences were statistically significant (P ＜ 0.05). The adverse reaction rate of the Lamotrigine dicconnection group was lower than that of the drug addition group, and the difference was statistically significant (P ＜ 0.05). Conclusion The addition of Lamotrigine combined with cerebral hemisphere ring insular lobe transection has a definite effect in the treatment of patients with valproic acid ineffective epilepsy, with fewer adverse reactions, and has a significant effect in improving patients’ cognitive function and hippocampal tissue metabolism.
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