Bourgeois B F
Department of Neurology, Harvard Medical School, Children's Hospital, Boston, Massachusetts 02115, USA.
Epilepsia. 1998 Sep;39(9):913-21. doi: 10.1111/j.1528-1157.1998.tb01440.x.
Cognitive and behavioral impairments are found more often among epileptic children than among their peers. The cause of these impairments is multifactorial. Identifying the relative contribution of antiepileptic drugs (AEDs) to these problems has been the object of a large number of clinical investigations. This area of research has been characterized by an unusually high number of methodological challenges and pitfalls. Accordingly, results have often been inconsistent and contradictory, except for the more obvious observations that can be derived from clinical experience. Overall, the effects of AEDs on cognition and behavior in children have been overrated in the past. More recent research has benefited from the methodological lessons of previous studies and it suggests that the majority of children taking AEDs do not experience clinically relevant cognitive of behavioral adverse effects from these medications. In addition, some of the newer AEDs may indeed have a better cognitive profile. Nevertheless, clinical experience must be used to identify the subgroup of children who remain at risk for significant and clinically relevant cognitive and behavioral adverse effects of AEDs.
认知和行为障碍在癫痫儿童中比在他们的同龄人中更常见。这些障碍的原因是多方面的。确定抗癫痫药物（AEDs）对这些问题的相对影响一直是大量临床研究的目标。该研究领域存在异常多的方法学挑战和陷阱。因此，除了从临床经验中可以得出的更明显的观察结果外，结果往往不一致且相互矛盾。总体而言，过去AEDs对儿童认知和行为的影响被高估了。最近的研究从以前研究的方法学经验中受益，并且表明大多数服用AEDs的儿童没有经历这些药物产生的具有临床相关性的认知或行为不良反应。此外，一些新型AEDs可能确实具有更好的认知特征。然而，必须利用临床经验来确定仍有风险因AEDs而出现显著且具有临床相关性的认知和行为不良反应的儿童亚组。
