Study of Cognitive and Behavioral Impacts of Idiopathic Epilepsy and Antiepileptic Drugs (AEDs) in Children and Adolescents

Background: Epilepsy is a common neurological condition that can have a detrimental impact on social, emotional, and cognitive functioning. Psychiatric and cognitive problems in children with epilepsy and antiepileptic drugs can affect quality of life. Long-term follow-up studies reveal that epilepsy that develops in childhood is more common than epilepsy that develops later in life. Has a marked impact on adult life even when the epilepsy is not complicated by intellectual disability or other neurological impairments. The aim of this study was to study cognitive and behavioral impacts of idiopathic epilepsy and antiepileptic drugs in children and adolescents compared to normal ones.

Methods: This prospective, case control study was conducted on 60 children or adolescents suffering from idiopathic epilepsy aged 6-16 years. Children were classified into four equal groups and were examined after 6 months from diagnosis: Group A subjected to valproic acid at a dose of 10-60 mg/kg/day, group B subjected to Carbamazepine at a dose of 10-30 mg/kg/day, group C subjected to levetiracetam at a dose of 10-60 mg/kg/day and group D subjected to Oxcarbazepine at a dose of 20-30 mg/kg/day. Thirty healthy children or adolescents of matched age and sex served as a control group who attended Pediatric General Outpatient Clinic of Tanta University Hospitals. The following was done to all of the patients: full history taking, complete physical examination, routine laboratory investigations, electroencephalography, brain magnetic resonance imaging, specific tests for behavior and executive functions including the Child Behavior Checklist – school age, Stanford-Binet Intelligence Scales (fifth version), Wisconsin Card Sorting Test and Continuous Performance Test. Thirty healthy children or adolescents of matched age and sex served as a control group.

Results: Children with epilepsy who were treated with AEDs showed higher behavioral problems scales, lower mean IQ and lower executive functions as compared to controls. LEV and VPA had a more negative effect on behavior than CBZ and OXC while VPA and CBZ had a more negative effect on mean IQ and executive functions than LEV and OXC.

Conclusion: Antiepileptic drugs (AEDs) may be one of the causes of epilepsy-related cognitive and behavioral issues in children.