Perampanel tolerability in children and adolescents with focal epilepsy: Effects on behavior and executive functions

Operto, Francesca Felicia; Pastorino, Grazia Maria Giovanna; Mazza, Roberta; Bonaventura, Carlo Di; Matricardi, Sara; Verrotti, Alberto; Carotenuto, Marco; Viggiano, Andrea; Coppola, Giangennaro; Elia, Maurizio

doi:10.1016/j.yebeh.2019.106879

Cited by 35 publications

(48 citation statements)

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“…Internalizing behavioral problems were reported to the same extent as externalizing behavioral problems. Somatic complaints as well as anxiety and mood problems, which are in general reported frequently in epilepsy, were reported to a lesser extent [80,81,[91][92][93]96,97,100].…”

Section: Used Toolsmentioning

confidence: 94%

“…Behavioral problems were found in 20 (77%) studies [6,9,25,68,[80][81][82][83][84][85][86]89,91,[93][94][95][96][97]99,100] varying from (mild) attentional to aggression problems. Internalizing behavioral problems were reported to the same extent as externalizing behavioral problems.…”

Section: Used Toolsmentioning

confidence: 99%

“…The epilepsy variables most associated with different behavioral problems and/ or cognitive deficits were early age at onset in 5 studies [2,6,9,85,96] and high seizure frequency in 5 studies [9,81,89,99,100]. However, four studies reported these variables not to be of influence [6,68,89,93]. Furthermore, duration of epilepsy is reported in relation to cognition [85] and behavior [93,96], while two other studies reported no association [68,89].…”

Section: Which Epilepsy Variables Can Be Identified As Important (Possible Causal) Factors?mentioning

confidence: 99%

“…However, four studies reported these variables not to be of influence [6,68,89,93]. Furthermore, duration of epilepsy is reported in relation to cognition [85] and behavior [93,96], while two other studies reported no association [68,89]. Five studies reported the effect of ASM specifically [2,6,93,94,98].…”

Section: Which Epilepsy Variables Can Be Identified As Important (Possible Causal) Factors?mentioning

confidence: 99%

“…Furthermore, duration of epilepsy is reported in relation to cognition [85] and behavior [93,96], while two other studies reported no association [68,89]. Five studies reported the effect of ASM specifically [2,6,93,94,98]. Newer ASMs, such as perampanel, oxcarbazepine and lamotrigine seem to have fewer cognitive and behavioral side effects than older ASMs such as valproate [98] and, to a lesser extent, carbamazepine.…”

Section: Which Epilepsy Variables Can Be Identified As Important (Possible Causal) Factors?mentioning

confidence: 99%

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Epilepsy out of control: when frontal lobe epilepsy becomes more than seizures

Berg

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IntroductionAs children with epilepsy may have a number of learning and behavioral problems, it is important that insight into the underlying neurocognitive differences in these children, which may underlie these areas of challenge is gained. Executive function (EF) problems particularly are associated with specific learning abilities as well as behavioral problems. We aim to review systematically the current status of empirical studies on the association between EF problems and behavior and socioemotional problems in children with epilepsy. MethodsStudies were identified using Pubmed and Web of Science, whilst following the PRISMA guidelines. All studies were assessed for methodological quality and results were summarized descriptively. ResultsAfter search, 26 empirical studies were identified, most of them of moderate quality. Overall, attention problems were the most reported cognitive deficit in test assessment and the most reported problem by parents. In 54% of the studies, children with epilepsy scored below average compared to controls/normative samples on different aspects of EF. Most studies reported behavior problems, which ranged from mild to severe. Forty-two percent of the studies specifically reported relationships between EF deficits and behavioral problems. In the remaining studies, below average neuropsychological functioning seemed to be accompanied by above average reported behavioral problems. ConclusionsCognitive control and attention deficits seem mostly associated with especially externalizing behavioral problems. The epilepsy variables early age at seizure onset and high seizure frequency are important variables in the relationship between EF and behavior. Future research should distinguish specific aspects of EF and take age into account, as this provides more insight on the association between EF and behavior in pediatric epilepsy, which makes it possible to develop appropriate and early intervention. CHAPTER 1 Social functioningEF also encompasses behaviors necessary for social interaction, such as initiation, self-monitoring, and self-regulation [14], which may be essential for adequate social functioning [63]. To engage in successful social interaction it is essential 292 Associating executive dysfunction with behavioral and socioemotional problems in children with epilepsy: a systematic review 65 2 Associating executive dysfunction with behavioral and socioemotional problems in children with epilepsy: a systematic review

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Section: Used Toolsmentioning

confidence: 94%

Section: Used Toolsmentioning

confidence: 99%

Section: Which Epilepsy Variables Can Be Identified As Important (Possible Causal) Factors?mentioning

confidence: 99%

Section: Which Epilepsy Variables Can Be Identified As Important (Possible Causal) Factors?mentioning

confidence: 99%

Section: Which Epilepsy Variables Can Be Identified As Important (Possible Causal) Factors?mentioning

confidence: 99%

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Epilepsy out of control: when frontal lobe epilepsy becomes more than seizures

Berg

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Psychobehavioural and Cognitive Adverse Events of Anti-Seizure Medications for the Treatment of Developmental and Epileptic Encephalopathies

Strzelczyk

Schubert‐Bast

2022

CNS Drugs

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The developmental and epileptic encephalopathies encompass a group of rare syndromes characterised by severe drug-resistant epilepsy with onset in childhood and significant neurodevelopmental comorbidities. The latter include intellectual disability, developmental delay, behavioural problems including attention-deficit hyperactivity disorder and autism spectrum disorder, psychiatric problems including anxiety and depression, speech impairment and sleep problems. Classical examples of developmental and epileptic encephalopathies include Dravet syndrome, Lennox–Gastaut syndrome and tuberous sclerosis complex. The mainstay of treatment is with multiple anti-seizure medications (ASMs); however, the ASMs themselves can be associated with psychobehavioural adverse events, and effects (negative or positive) on cognition and sleep. We have performed a targeted literature review of ASMs commonly used in the treatment of developmental and epileptic encephalopathies to discuss the latest evidence on their effects on behaviour, mood, cognition, sedation and sleep. The ASMs include valproate (VPA), clobazam, topiramate (TPM), cannabidiol (CBD), fenfluramine (FFA), levetiracetam (LEV), brivaracetam (BRV), zonisamide (ZNS), perampanel (PER), ethosuximide, stiripentol, lamotrigine (LTG), rufinamide, vigabatrin, lacosamide (LCM) and everolimus. Bromide, felbamate and other sodium channel ASMs are discussed briefly. Overall, the current evidence suggest that LEV, PER and to a lesser extent BRV are associated with psychobehavioural adverse events including aggressiveness and irritability; TPM and to a lesser extent ZNS are associated with language impairment and cognitive dulling/memory problems. Patients with a history of behavioural and psychiatric comorbidities may be more at risk of developing psychobehavioural adverse events. Topiramate and ZNS may be associated with negative effects in some aspects of cognition; CBD, FFA, LEV, BRV and LTG may have some positive effects, while the remaining ASMs do not appear to have a detrimental effect. All the ASMs are associated with sedation to a certain extent, which is pronounced during uptitration. Cannabidiol, PER and pregabalin may be associated with improvements in sleep, LTG is associated with insomnia, while VPA, TPM, LEV, ZNS and LCM do not appear to have detrimental effects. There was variability in the extent of evidence for each ASM: for many first-generation and some second-generation ASMs, there is scant documented evidence; however, their extensive use suggests favourable tolerability and safety (e.g. VPA); second-generation and some third-generation ASMs tend to have the most robust evidence documented over several years of use (TPM, LEV, PER, ZNS, BRV), while evidence is still being generated for newer ASMs such as CBD and FFA. Finally, we discuss how a variety of factors can affect mood, behaviour and cognition, and untangling the associations between the effects of the underlying syndrome and those of the ASMs can be challenging. In particular, there is enormous h...

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Neurocognitive Effects of Antiseizure Medications in Children and Adolescents with Epilepsy

Besag

Vasey

2021

Pediatr Drugs

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Perampanel tolerability in children and adolescents with focal epilepsy: Effects on behavior and executive functions

Cited by 35 publications

References 23 publications

Epilepsy out of control: when frontal lobe epilepsy becomes more than seizures

Epilepsy out of control: when frontal lobe epilepsy becomes more than seizures

Psychobehavioural and Cognitive Adverse Events of Anti-Seizure Medications for the Treatment of Developmental and Epileptic Encephalopathies

Neurocognitive Effects of Antiseizure Medications in Children and Adolescents with Epilepsy

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