Kim Sun Jun, Kim Moon Yeon, Choi Yoon Mi, Song Mi Kyoung
Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Jeonbuk, Korea.
Department of Pediatrics, Chonbuk National University Medical School, Jeonju, Jeonbuk, Korea.
Pediatr Neurol. 2014 Sep;51(3):324-9. doi: 10.1016/j.pediatrneurol.2014.05.033. Epub 2014 Jun 6.
The aim of this study was to characterize the effects of topiramate on language functions in newly diagnosed pediatric epileptic patients.
Thirty-eight newly diagnosed epileptic patients were assessed using standard language tests. Data were collected before and after beginning topiramate during which time a monotherapy treatment regimen was maintained. Language tests included the Test of Language Problem Solving Abilities, a Korean version of the Peabody Picture Vocabulary Test. We used language tests in the Korean version because all the patients were spoken Korean exclusively in their families.
All the language parameters of Test of Language Problem Solving Abilities worsened after initiation of topiramate (determine cause, 13.2 ± 4.8 to 11.2 ± 4.3; problem solving, 14.8 ± 6.0 to 12.8 ± 5.0; predicting, 9.8 ± 3.6 to 8.8 ± 4.6). Patients given topiramate exhibited a shortened mean length of utterance in words during response (determine cause, 4.8 ± 0.9 to 4.3 ± 0.7; making inference, 4.5 ± 0.8 to 4.1 ± 1.1; predicting, 5.2 ± 1.0 to 4.7 ± 0.6; P < 0.05), provided ambiguous answers during the testing, exhibited difficulty in selecting appropriate words, took more time to provide answers, and used incorrect grammar. However, there were no statistically significant changes in the receptive language of patients after taking topiramate (95.4 ± 20.4 to 100.8 ± 19.1).
Our data suggest that topiramate may have negative effects on problem-solving abilities in children. We recommend performing language tests should be considered in children being treated with topiramate.
本研究旨在明确托吡酯对新诊断的小儿癫痫患者语言功能的影响。
使用标准语言测试对38例新诊断的癫痫患者进行评估。在开始托吡酯治疗前及治疗期间收集数据,治疗期间维持单一疗法治疗方案。语言测试包括语言问题解决能力测试、韩语版皮博迪图片词汇测试。我们使用韩语版语言测试是因为所有患者在家中只说韩语。
开始使用托吡酯后,语言问题解决能力测试的所有语言参数均恶化(确定原因,从13.2±4.8降至11.2±4.3;解决问题,从14.8±6.0降至12.8±5.0;预测,从9.8±3.6降至8.8±4.6)。接受托吡酯治疗的患者在回答问题时平均话语长度缩短(确定原因,从4.8±0.9降至4.3±0.7;进行推理,从4.5±0.8降至4.1±1.1;预测,从5.2±1.0降至4.7±0.6;P<0.05),在测试期间给出模糊答案,在选择合适词汇方面存在困难,回答问题花费更多时间,且使用不正确的语法。然而,服用托吡酯后患者的接受性语言没有统计学上的显著变化(从95.4±20.4升至100.8±19.1)。
我们的数据表明托吡酯可能对儿童的问题解决能力有负面影响。我们建议对接受托吡酯治疗的儿童应考虑进行语言测试。