Intellectual and language functions in children of mothers with epilepsy

Abstract

SUMMARYPurpose: To compare the intellectual and language functions of children of mothers with epilepsy (CME) with that of controls matched for age and socioeconomic status. Methods: Cases were CME, aged six years or more (n = 71), drawn from a prospective cohort in the Kerala Registry of Epilepsy and Pregnancy. Controls were 201 children of parents without epilepsy, matched for age and socioeconomic status. The outcome measures included Indian adaptation of Wechsler Intelligence Scale for children and MLTa locally developed proficiency test for regional language. All relevant data were abstracted from the registry records. Results: The Full Scale IQ and MLT scores were significantly lower for the cases (87.7 ± 22.6 and 73.4 ± 17.3) compared to controls (93.0 ± 14.4 and 83.2 ± 11.8). Compared to controls, CME scored poor on all subtests of MLT but their impairment was confined to only some of the subtests of IQ. Maternal education and maternal IQ significantly correlated with low IQ and MLT scores for CME whereas type of epilepsy, seizures during pregnancy or low birth weight did not have any significant association with these outcome measures. Polytherapy and higher dosage of antiepileptic drugs (AEDs) were associated with significant impairment in outcome measures. Infants with low developmental quotient at one year of age continued to have low scores on outcome measures at six years. Conclusions: Low maternal IQ, maternal education, and antenatal AED exposure were associated with significant impairment of intellectual and language functions for CME at six years.

Children (10–12 years age) of women with epilepsy have lower intelligence, attention and memory: Observations from a prospective cohort case control study

“…There is growing body of evidence that antenatal exposure to AEDs particularly valproate (VPA) increases the risk for poorer cognitive abilities in children (Adab et al, 2001(Adab et al, , 2004Banach et al, 2010;Gaily et al, 2004;Kantola-Sorsa et al, 2007;Meador et al, 2009;Thomas et al, 2007;Vinten et al, 2009).…”

IQ at 6 years after in utero exposure to antiepileptic drugs

“…1 Determining the association between exposure to AEDs and child cognitive functioning represents a challenge, and a number of different methodologies have been utilized in its investigation including case studies, [2][3][4] retrospective studies, 5,6 and prospective studies. [7][8][9][10][11][12][13][14][15] Despite limitations, 16 there is growing evidence that exposure to sodium valproate (VPA) in utero is associated with significantly poorer functioning. [10][11][12]15,17 Prospective studies consistently document that VPA is associated with an increase in risk of cognitive impairment in young children, 10,12,15 but any longer-term effects are unlikely to be comprehensively documented until the children studied are of school age, when cognitive development is more stable.…”

Neurodevelopmental effects of prenatal exposure to psychotropic medications

“…[53,54] On the other hand, it must be stressed that concerns regarding the impact of in utero exposure to CBZ on the infant cognitive and motor development were reported by studies that lumped together data coming from different AEDs [55,56] and studies that analyzed the potential neurobehavioral toxicity of single AEDs. [57] Of note, the latter [57] demonstrated that both poor maternal education and low IQ may also compromise the infant developmental outcomes.…”

“…VPA is the psychotropic agent that shows the highest number of reports suggesting that it seriously interferes with several areas of infant development. Reduced IQ scores, [50,57] impaired verbal acquisition, [58,60] increased frequency of maladaptive behavior, [68] as well as global neurodevelopmental delay [61,63] have indeed been reported in children whose mothers took VPA during pregnancy. The risk of VPA-induced neurodevelopmental impairment seems to be dose-dependent, and even more particularly relevant if the drug is used in combination with other AEDs.…”