The Efficacy of Combined Lamotrigine and Levetiracetam Therapy in Epileptic Patients and Its Effects on Hippocampal Volume and Neuroinflammatory Response.

Objective: To analyze the efficacy of combined lamotrigine and levetiracetam therapy in epileptic patients and its impact on hippocampal volume and inflammatory response. Methods: A retrospective analysis was conducted on the clinical data of 120 epileptic patients admitted to our hospital from December 2022 to February 2024. All patients met the inclusion and exclusion criteria. Based on the treatment received, patients were divided into a control group (n=60, treated with lamotrigine) and an observation group (n=60, treated with lamotrigine combined with levetiracetam). Clinical efficacy, bilateral hippocampal volume, inflammatory factors, brain injury markers, and adverse reactions were compared between the two groups. Results: ① Clinical efficacy: The observation group had higher effective rates in seizure control and EEG epileptiform discharge improvement than the control group (P<0.05). ② Hippocampal volume: No significant differences were observed in bilateral hippocampal volume changes between the two groups before and after treatment (P>0.05). ③ Inflammatory factors: TNF-α, hs-CRP, and IL-6 levels decreased in both groups after treatment, with greater reductions in the observation group (P<0.05). ④ Brain injury markers: S-100β and HMGB-1 levels decreased in both groups after treatment, with greater reductions in the observation group (P<0.05). ⑤ Adverse reactions: The incidence of adverse reactions was comparable between the two groups (P>0.05). Conclusion: Compared with lamotrigine monotherapy, lamotrigine combined with levetiracetam further improves treatment efficacy in epileptic patients, reduces inflammatory response and brain injury, and does not increase the risk of adverse reactions.