Pulliainen V, Jokelainen M
Department of Neurology, Central Hospital of Päijät-Häme, Lahti, Finland.
Epilepsia. 1995 Dec;36(12):1195-202. doi: 10.1111/j.1528-1157.1995.tb01062.x.
We compared the cognitive effects of randomly prescribed phenytoin (PHT) and carbamazepine (CBZ) therapy on newly diagnosed patients with epilepsy in a 2-year parallel group follow-up study. Fifteen patients were receiving PHT and 16 were receiving CBZ. Neuropsychological assessments were conducted before the treatment and after 6 and 24 months of steady-state drug therapy. Differential effects of PHT and CBZ during follow-up were observed in 3 of 32 measurements. PHT appeared to have negative effects on visually guided motor speed of both hands. In addition, the performance of the PHT group as compared with the CBZ group developed less positively in one visual memory task. The development of mood as measured by Profile of Mood States (POMS), was quite similar in both drug groups; Tension, Depression, and Bewilderment decreased and Vigor increased during the follow-up. The results suggest that the long-term effects of PHT as compared with those of CBZ on cognition are few and restricted mainly to some visually guided motor functions. The effects of PHT on cerebellar function as a possible mechanism for these changes is discussed.
在一项为期2年的平行组随访研究中，我们比较了随机开具的苯妥英（PHT）和卡马西平（CBZ）治疗对新诊断癫痫患者的认知影响。15名患者接受PHT治疗，16名患者接受CBZ治疗。在治疗前以及稳态药物治疗6个月和24个月后进行神经心理学评估。在32项测量中有3项观察到随访期间PHT和CBZ的不同效果。PHT似乎对双手的视觉引导运动速度有负面影响。此外，在一项视觉记忆任务中，与CBZ组相比，PHT组的表现改善不太明显。通过情绪状态剖面图（POMS）测量的情绪变化，在两个药物组中相当相似；随访期间，紧张、抑郁和困惑感降低，活力增加。结果表明，与CBZ相比，PHT对认知的长期影响较少，主要局限于一些视觉引导的运动功能。本文讨论了PHT对小脑功能的影响，这可能是这些变化的一种机制。
