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首页> 外文期刊>European journal of neurology: the official journal of the European Federation of Neurological Societies >Levetiracetam in patients with central neuropathic post-stroke pain - a randomized, double-blind, placebo-controlled trial
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Levetiracetam in patients with central neuropathic post-stroke pain - a randomized, double-blind, placebo-controlled trial

机译：左乙拉西坦用于中风后神经痛的患者-一项随机，双盲，安慰剂对照试验

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Background and purpose: Central post-stroke pain (CPSP) is a severe chronic neuropathic pain condition defined as a spontaneous pain or allodynia corresponding to a vascular lesion. It usually evolves weeks after stroke, and can distinctively impair the quality of life. Treatment is complex and mostly unsatisfactory. We hypothesized that the anti-epileptic drug levetiracetam (LEV) improves CPSP compared with placebo. The purpose of this study was to examine the efficacy and tolerability of LEV in patients with CPSP. Methods: In a double-blind, placebo-controlled, crossover study design patients with CPSP lasting at least 3 months and a pain score ≥ 4 on the 11-point Likert scale were treated over two 8-week periods with a maximum dose up to 3000 mg LEV or placebo. Primary endpoint was a median pain lowering ≥ 2 in the final treatment week compared with the last baseline week. Secondary outcome measures comprised additional pain ratings, depression, sleep quality, quality of life and patients' global impression of change. Results: Of 42 patients, 33 [61.5 years (40-76); 38% women] completed the study. Side effects and withdrawals were more frequent in the LEV (n = 5) group than in the placebo group (n = 1). Patients treated with LEV did not show any improvement of pain or changes in secondary outcome parameters compared with placebo. Conclusions: LEV is not effective in treatment for CPSP. The mode of action of LEV does not exert an analgesic effect in chronic CPSP.
机译：背景与目的：中风后中枢性疼痛（CPSP）是一种严重的慢性神经性疼痛，定义为自发性疼痛或异常性疼痛，与血管病变相对应。它通常在中风后数周发生，并可能明显损害生活质量。治疗很复杂，而且大多不能令人满意。我们假设抗癫痫药左乙拉西坦（LEV）与安慰剂相比可改善CPSP。这项研究的目的是检查LEV对CPSP患者的疗效和耐受性。方法：在一项双盲，安慰剂对照，交叉研究设计中，CPSP持续至少3个月且11点Likert量表的疼痛评分≥4的患者接受了两个8周的治疗，最大剂量为3000 mg LEV或安慰剂。主要终点是最后一个治疗周与最后一个基准周相比中位疼痛降低≥2。次要结果指标包括其他疼痛等级，抑郁，睡眠质量，生活质量和患者对变化的总体印象。结果：42例患者中，有33例[61.5岁（40-76岁）; 38％的女性]完成了研究。与安慰剂组（n = 1）相比，LEV组（n = 5）的副作用和停药更为频繁。与安慰剂相比，接受LEV治疗的患者的疼痛或继发性结局参数没有任何改善。结论：LEV不能有效治疗CPSP。 LEV的作用方式在慢性CPSP中不发挥镇痛作用。

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