Gopinath Neelima, Muneer Anila K, Unnikrishnan Syam, Varma Ravi Prasad, Thomas Sanjeev V
Kerala Registry of Epilepsy and Pregnancy, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India.
Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, India.
Epilepsy Res. 2015 Nov;117:58-62. doi: 10.1016/j.eplepsyres.2015.09.003. Epub 2015 Sep 9.
To compare the cognitive outcome of children of women with epilepsy (CWE) with matched controls (CWO).
CWE (10-12 years) under follow up in Kerala Registry of Epilepsy and Pregnancy (n=190) were evaluated with WISC-IV, Trail Making Test (TMT), Rey Auditory Verbal Learning Test (RAVLT) and compared with age and sex matched children of women without epilepsy - CWO (n=149) drawn from schools in the same region. The dosage was expressed as prescribed daily dose/daily-defined dose (PDD/DDD) ratio in order to make comparisons.
The Full Scale IQ of CWE (77.9 ± 14.6) was 8.5 points lower than that of CWO (86.4 ± 13.4), which was statistically significant (p=0.001). They performed lower on TMT Part A & B and RAVLT. The FSIQ mean ± SD; PDD/DDD ratio and number of monotherapy exposure for different anti-epileptic drugs were phenobarbital: (74.5 ± 14; 1.1 ± 0.8; 22), valproate: (82.8 ± 12.4; 0.3 ± 0.1; 36), carbamazepine: (82.2 ± 13.9; 0.6 ± 0.3; 41), phenytoin: (82.6 ± 13.5; 0.8±0.3; 11). The FSIQ for those exposed to phenobarbital was significantly (p=0.01) lower than others. The significant predictors of FSIQ differed at lower and higher ends of its spectrum. These predictors were low body mass index and low maternal education for FSIQ<80 and low maternal education, low maternal IQ and high anti-epileptic drug dosage for FSIQ<86. High anti-epileptic drug dosage, low maternal IQ, and low paternal education were the predictors for FSIQ<92.
The IQ, attention and memory were significantly lower for 10-12 year old CWE when compared to CWO. The important predictors of low FSIQ were antiepileptic drug dosage, maternal IQ, and parental education.
比较癫痫女性儿童（CWE）与匹配对照组儿童（CWO）的认知结局。
对喀拉拉邦癫痫与妊娠登记处随访的10至12岁CWE（n = 190）进行韦氏儿童智力量表第四版（WISC-IV）、连线测验（TMT）、雷伊听觉词语学习测验（RAVLT）评估，并与来自同一地区学校的年龄和性别匹配的无癫痫女性儿童——CWO（n = 149）进行比较。为便于比较，剂量以规定日剂量/限定日剂量（PDD/DDD）比值表示。
CWE的全量表智商（77.9±14.6）比CWO（86.4±13.4）低8.5分，差异具有统计学意义（p = 0.001）。他们在TMT A部分和B部分以及RAVLT中的表现较差。不同抗癫痫药物的全量表智商平均值±标准差、PDD/DDD比值及单药治疗暴露次数分别为：苯巴比妥：（74.5±14；1.1±0.8；22），丙戊酸盐：（82.8±12.4；0.3±0.1；36），卡马西平：（82.2±13.9；0.6±0.3；41），苯妥英：（82.6±13.5；0.8±0.3；11）。暴露于苯巴比妥的儿童全量表智商显著低于其他儿童（p = 0.01）。全量表智商的显著预测因素在其范围的低端和高端有所不同。这些预测因素在全量表智商<80时为低体重指数和低母亲教育程度，在全量表智商<86时为低母亲教育程度、低母亲智商和高抗癫痫药物剂量。高抗癫痫药物剂量、低母亲智商和低父亲教育程度是全量表智商<92的预测因素。
与CWO相比，10至12岁CWE的智商、注意力和记忆力显著较低。全量表智商低的重要预测因素是抗癫痫药物剂量、母亲智商和父母教育程度。
