Comments on Ortinski P et al. Cognitive side effects of antiepileptic drugs. Epilepsy &amp; Behavior 2004;5(Suppl. 1):S60–65.

Helmstaedter, Christoph

doi:10.1016/j.yebeh.2014.09.073

Cited by 5 publications

(5 citation statements)

References 39 publications

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“…Of the variables assessed, the extent of epileptogenic foci and the percentage of life with epilepsy were the strongest predictors and remained significant in multivariable analyses. A greater number of AEDs may be a proxy for seizure severity and may be associated with cognitive and behavioral side effects of AEDs (Helmstaedter & Witt, 2014). Adverse side effects of AEDs may be especially pronounced among children taking older (first-generation) AEDs and among patients with previous or current behavioral or cognitive problems which may be exacerbated (Eddy, Rickards, & Cavanna, 2012; Helmstaedter & Witt, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…A greater number of AEDs may be a proxy for seizure severity and may be associated with cognitive and behavioral side effects of AEDs (Helmstaedter & Witt, 2014). Adverse side effects of AEDs may be especially pronounced among children taking older (first-generation) AEDs and among patients with previous or current behavioral or cognitive problems which may be exacerbated (Eddy, Rickards, & Cavanna, 2012; Helmstaedter & Witt, 2014). However, it is difficult to disentangle the potential effects of AEDs from effects due to preexisting disorders, ongoing seizures, individual vulnerabilities or other factors.…”

Section: Discussionmentioning

confidence: 99%

“…Indeed, different neurocognitive systems are not uniformly affected by family factors in the general population (Hackman & Farah, 2009). In addition, there were a number of potentially important epilepsy-related variables that we were unable to include in our analyses, such as epilepsy etiology, for which information was not available for the majority of patients, or the type of AEDs, because different AEDs have differential effects on cognition (Aldenkamp et al, 2000; Helmstaedter & Witt, 2014; Loring, Marino, & Meador, 2007). Nonetheless, the present study identified a number of significant associations between epilepsy variables and IQ.…”

Section: Discussionmentioning

confidence: 99%

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The impact of family factors on IQ in pediatric medically refractory epilepsy.

Puka¹,

Smith²,

Widjaja³

2017

Neuropsychology

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The impact of family factors on IQ in pediatric medically refractory epilepsy.

Puka¹,

Smith²,

Widjaja³

2017

Neuropsychology

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“…The presence and severity of cognitive drug side effects depend on the substance, on the dose and total drug load if more than one drug is administered, and on titration speed ( see Helmstaedter and Witt [2014]). In addition to the impact of each individual medication, the drug load, i.e .…”

Section: Contribution To Seizure Characterization and Lateralization/...mentioning

confidence: 99%

Indications and expectations for neuropsychological assessment in epilepsy surgery in children and adults

Baxendale

Wilson

Baker

et al. 2019

Epileptic Disorders

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In our first paper in this series ( Epilepsia 2015; 56(5): 674–681), we published recommendations for the indications and expectations for neuropsychological assessment in routine epilepsy care. This partner paper provides a comprehensive overview of the more specialist role of neuropsychological assessment in the pre and postoperative evaluation of epilepsy surgery patients. The paper is in two parts. The first part presents the framework for the mandatory role of neuropsychologists in the presurgical evaluation of epilepsy surgery candidates. A preoperative neuropsychological assessment should be comprised of standardised measures of cognitive function in addition to wider measures of behavioural and psychosocial function. The results from the presurgical assessment are used to: (1) establish a baseline against which change can be measured following surgery; (2) provide a collaborative contribution to seizure characterization, lateralization and localization; (3) provide evidence‐based predictions of cognitive risk associated with the proposed surgery; and (4) provide the evidence base for comprehensive preoperative counselling, including exploration of patient expectations of surgical treatment. The second part examines the critical role of the neuropsychologist in the evaluation of postoperative outcomes. Neuropsychological changes following surgery are dynamic and a comprehensive, long‐term assessment of these changes following surgery should form an integral part of the postoperative follow‐up. The special considerations with respect to pre and postoperative assessment when working with paediatric populations and those with an intellectual disability are also discussed. The paper provides a summary checklist for neuropsychological involvement throughout the epilepsy surgery process, based on the recommendations discussed.

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“…The occurrence and severity of adverse cognitive side effects of AEDs depends on the pharmacological agent, titration speed, dose, and, when given in combination therapy, on the total drug load and on potential interactions of concurrent drugs. As indicated by reviews there are drugs which are less likely or more likely associated with negative side effects, even when given in monotherapy [64,65]. However, cognitive impairments in the context of AED pharmacotherapy cannot be considered as independent of the disease, in that they are mostly the result of a synergy of having epilepsy, being treated at all, and being treated with a specific drug or drug combination [66].…”

Section: Advances In Monitoring Antiepileptic Drug (Aed) Treatmentmentioning

confidence: 99%

How neuropsychology can improve the care of individual patients with epilepsy. Looking back and into the future

Helmstaedter

2017

Seizure

Self Cite

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Some of the roots of current clinical neuropsychology go back to the early days of epilepsy surgery. Looking back a huge number of publications have dealt with cognition in epilepsy. The major factors driving this work were questions relating to surgery, antiepileptic drugs and, more recently, also to underlying pathology. However, most factors affecting cognition in epilepsy have been discerned many years ago. The body of neuropsychological literature in this field has accumulated much knowledge, raising the question why, apart from epilepsy surgery settings, neuropsychology has still not been fully integrated in the routine care of patients with epilepsy. This review on the occasion of Seizure's 25th anniversary attempts to summarize clinically relevant diagnostic advances following a question guided, modular, and evidence-based approach. In doing so, we hope to attract the interest of readers to an exciting mode of assessment which does not only have theoretical but also practical relevance. The comorbidities of epilepsy are becoming an increasingly relevant topic. It is now widely accepted that, while epilepsy may be defined by the occurrence of epileptic seizures, these seizures represent only one of several possible sources of cognitive impairment. It is well-established that there are complex interactions between epilepsy, cognition and behavior, and that both seizures and problems with cognition or behavior may result from a common underlying pathology requiring treatment. With this review we aim to demonstrate that neuropsychology can make a highly valuable contribution to the care of individual patients by contributing to the diagnostic process and by serving as a tool for the monitoring of disease and treatment, thereby improving the quality and safety of patient care. On a national, European, and international level, first efforts are being made to homogenize diagnostics across epilepsy centers and countries in order to achieve a common language and core standards. This should improve communication within and outside the speciality, and help to generate the data required to allow the field to make further progress.

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Comments on Ortinski P et al. Cognitive side effects of antiepileptic drugs. Epilepsy & Behavior 2004;5(Suppl. 1):S60–65.

Cited by 5 publications

References 39 publications

The impact of family factors on IQ in pediatric medically refractory epilepsy.

The impact of family factors on IQ in pediatric medically refractory epilepsy.

Indications and expectations for neuropsychological assessment in epilepsy surgery in children and adults

How neuropsychology can improve the care of individual patients with epilepsy. Looking back and into the future

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