Cognitive and neurodevelopmental effects of antiepileptic drugs

Bromley, Rebecca; Leeman, Beth A.; Baker, Gus A.; Meador, Kimford J.

doi:10.1016/j.yebeh.2011.04.009

Cited by 32 publications

(24 citation statements)

References 73 publications

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“…Better postoperative development outcomes have been noted in children under 3 years old, 30 and the likely explanations for these findings include greater neural plasticity of the brain at this age. 4,15,16,20,38,39 Furthermore, there is evidence that AEDs have an ominous role in cognitive development, 6,9,24,32 an effect that may add to the deleterious role of persistent seizures. 23 Despite recent publications on specific subpopulations of patients demonstrating that various procedures for refractory epilepsies are safe in very young patients, 7 the invasiveness of the procedure and potential complications of surgical interventions may discourage pediatricians and neuropediatricians from referring their patients for early surgery.…”

Section: 21mentioning

confidence: 99%

Pediatric epilepsy surgery: could age be a predictor of outcomes?

Jenny¹,

Smoll²,

Hassani³

et al. 2016

PED

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OBJECTIVE Like adults, many children suffering from intractable seizures benefit from surgical therapy. Although various reports indicate that early intervention may avoid severe developmental consequences often associated with intractable epilepsy, surgery is still considered a last option for many children. In this retrospective study, the authors aimed to determine whether pediatric epilepsy surgery, in particular during the first years of life, relates to measurable benefits. METHODS Data from 78 patients (age range 5 months to 17 years) who underwent epilepsy surgery at the Geneva and Lausanne University Hospitals between 1997 and 2012 were reviewed retrospectively. Patients were dichotomized into 2 groups: infants (≤ 3 years of age, n = 19), and children/adolescents (4–17 years of age, n = 59). Compared with children/adolescents, infants more often had a diagnosis of dysplasia (37% vs 10%, respectively; p < 0.05, chi-square test). RESULTS The overall seizure-free rate was 76.9%, with 89.5% in infants and 72.9% in the children/adolescents group. Infants were 2.76 times as likely to achieve seizure-free status as children/adolescents. Postoperative antiepileptic medication was reduced in 67.9% of patients. Only 11.4% of the patients were taking more than 2 antiepileptic drugs after surgery, compared with 43% before surgery (p < 0.0001). The overall complication rate was 15.1% (6.4% transient hemiparesis), and no major complications or deaths occurred. CONCLUSIONS The data show a high seizure-free rate in children ≤ 3 years of age, despite a higher occurrence of dysplastic, potentially ill-defined lesions. Pediatric patients undergoing epilepsy surgery can expect a significant reduction in their need for medication. Given the excellent results in the infant group, prospective studies are warranted to determine whether age ≤ 3 years is a predictor for excellent surgical outcome.

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Section: 21mentioning

confidence: 99%

Pediatric epilepsy surgery: could age be a predictor of outcomes?

Jenny¹,

Smoll²,

Hassani³

et al. 2016

PED

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“…The highest incidence of epilepsy occurs in infancy [47], and it affects 0.5–1% of children [48]. It is known that children with epilepsy shows commitment in quality of life, cognitive function and sleep [49], [50].…”

Section: Discussionmentioning

confidence: 99%

The relationship between epilepsy, sleep disorders, and attention deficit hyperactivity disorder (ADHD) in children: A review of the literature

2016

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ObjectiveTo analyze the relationship between epilepsy, sleep disorders, and attention deficit hyperactivity disorder (ADHD).Bibliographic searchA literature search of the PubMed database was performed using the following key words: epilepsy, sleep, and ADHD. In total, 91 articles were located in PubMed, 34 were selected for abstract reading and twelve articles were reviewed, in which the main objectives were examine the relationship between epilepsy, sleep and ADHD from several perspectives, including epidemiology, effect of comorbidities on academic performance and the factors leading to diagnostic difficulties among these three disordersResultsAmong the main findings, there were difficulties to start and maintain sleep in patients with epilepsy and ADHD, reduction in sleep efficiency, decreased seizure threshold, as well as behavioral and cognitive deficits in both groups.ConclusionsIt is important to know which symptom is the predominant one. For this reason, children and adolescents with epilepsy, ADHD and sleep disorders need to be assessed carefully before initiating treatment. Our review concluded that there is an important link in this pathological triad.

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“…Cognitive AEs related to treatment with CBZ or OXC are generally considered to be mild, mostly affecting psychomotor speed, attention, and memory [29,30].…”

Section: Carbamazepine and Oxcarbazepinementioning

confidence: 99%

“…In the elderly, it may induce Parkinsonism at low doses and after years of treatment [87,88]. VPA may induce mild cognitive adverse effects related to treatment, mostly affecting psychomotor speed, attention, and memory [29,30].…”

Section: Valproatementioning

confidence: 99%

Management of Adverse Effects of Mood Stabilizers

Murru

Popović

Pacchiarotti

et al. 2015

Curr Psychiatry Rep

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Mood stabilizers such as lithium and anticonvulsants are still standard-of-care for the acute and long-term treatment of bipolar disorder (BD). This systematic review aimed to assess the prevalence of their adverse effects (AEs) and to provide recommendations on their clinical management. We performed a systematic research for studies reporting the prevalence of AEs with lithium, valproate, lamotrigine, and carbamazepine/oxcarbazepine. Management recommendations were then developed. Mood stabilizers have different tolerability profiles and are eventually associated to cognitive, dermatological, endocrine, gastrointestinal, immunological, metabolic, nephrogenic, neurologic, sexual, and teratogenic AEs. Most of those can be transient or dose-related and can be managed by optimizing drug doses to the lowest effective dose. Some rare AEs can be serious and potentially lethal, and require abrupt discontinuation of medication. Integrated medical attention is warranted for complex somatic AEs. Functional remediation and psychoeducation may help to promote awareness on BD and better medication management.

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Cognitive and neurodevelopmental effects of antiepileptic drugs

Cited by 32 publications

References 73 publications

Pediatric epilepsy surgery: could age be a predictor of outcomes?

Pediatric epilepsy surgery: could age be a predictor of outcomes?

The relationship between epilepsy, sleep disorders, and attention deficit hyperactivity disorder (ADHD) in children: A review of the literature

Management of Adverse Effects of Mood Stabilizers

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