Antiepileptic drugs, cognitive function, and behavior in children
Michael R. Trimble, FRCP, FRCPsych
Institute of Neurology, Queen Square, London WC1N 3BG, England
Christine A. Cull, PhD
ALTHOUGH the majority of children with epilepsy are able to lead relatively normal lives, many are handicapped by learning and behavior problems. A number of factors are related to this, including epilepsy variables such as site of seizure and age at onset of seizure, electroencephalographic (EEG) abnormalities, presence or absence of brain damage, parental attitudes and adverse environmental factors. In addition, antiepileptic medication has in recent years become a focus of attention for researchers. Following a brief review of the literature in this field, some results are reported from a recently completed study at the National Hospitals for Nervous Diseases, Queen Square, London.
ANTIEPILEPTIC DRUGS AND COGNITIVE FUNCTION IN CHILDREN
Many of the earlier studies failed to note clear effects of anticonvulsant medication on cognitive function. For example, Holdsworth and Whitmore1 in a study of 64 children found no difference in their educational attainment regardless of whether or not phenobarbital was being prescribed. In contrast, Stores,2 in studies of children with epilepsy attending normal schools, commented, “phenytoin was associated with poor reading skills, and may have been associated with impaired attentiveness of various types.” Bennett-Levy and Stores,3 in a study of 25 children receiving any form of antiepileptic drug treatment, noted that they had significantly worse concentration, poorer processing ability, and were less alert than 14 children whose antiepileptic treatment had been discontinued. Interestingly, however, children taking carbamazepine alone or sodium valproate alone showed minimal differences from those in a discontinued treatment group.
Some studies have been specifically concerned with. . .