Aldenkamp A P, Alpherts W C, Sandstedt P, Blennow G, Elmqvist D, Heijbel J, Nilsson H L, Tonnby B, Wåhlander L, Wosse E
Department of Behavioural Research and Psychological Services, Epilepsy Centre Kempenhaeghe, Heeze, The Netherlands.
Epilepsia. 1998 Oct;39(10):1070-4. doi: 10.1111/j.1528-1157.1998.tb01292.x.
The cognitive complaints reported by children and their parents, as subjectively associated with antiepileptic drug (AED) treatment, were evaluated in seizure-free children before and after drug discontinuation. The aim of the design was to isolate the cognitive side effects of AEDs from other factors, such as the effect of seizures. Our inventory explored the following areas: "alertness," "concentration," "activation/ tiredness," "memory," "drowsiness," "depression," "aggressiveness," and "hyperactivity," using a 5-point Likert scaling procedure. One hundred two eligible patients were selected, each matched with a healthy control and assessed when still on antiepileptic medication. All children were seizure free for at least 1 year. The medication was then discontinued gradually over a 3-month period. Four months after the children were completely medication free, a second assessment was carried out, but only in the 83 children who remained seizure free and in their matched controls. The results of the reports made by the children themselves did not show differences with the matched controls, and only showed improvement after drug discontinuation for complaints about "tiredness." Parents of the children with epilepsy reported significant improvement in all areas related to "alertness and activation" after discontinuation of the drugs. The finding that only a limited number of children have cognitive complaints, both when still on AEDs and after discontinuation, may be in line with the reports that the major factor contributing to quality of life is whether patients are seizure free or still have seizures. All patients in this study were seizure free for a period >1 year, which may have caused the favorable pattern of response in our patient group.
在停药前后，对无癫痫发作儿童所报告的、主观上与抗癫痫药物（AED）治疗相关的认知主诉进行了评估。该设计的目的是将AED的认知副作用与其他因素（如癫痫发作的影响）区分开来。我们的调查问卷探讨了以下领域：“警觉性”、“注意力”、“活跃度/疲劳度”、“记忆力”、“嗜睡”、“抑郁”、“攻击性”和“多动”，采用5点李克特量表程序。选择了102名符合条件的患者，每名患者与一名健康对照匹配，并在仍服用抗癫痫药物时进行评估。所有儿童至少1年无癫痫发作。然后在3个月的时间内逐渐停药。在儿童完全停药4个月后，进行了第二次评估，但仅针对83名仍无癫痫发作的儿童及其匹配的对照。儿童自己报告的结果与匹配的对照没有差异，仅在停药后“疲劳”主诉方面有所改善。癫痫患儿的家长报告称，停药后在与“警觉性和活跃度”相关的所有方面都有显著改善。研究发现，无论是在仍服用AED期间还是停药后，只有少数儿童有认知主诉，这可能与关于影响生活质量的主要因素是患者是否无癫痫发作还是仍有癫痫发作的报告一致。本研究中的所有患者无癫痫发作的时间超过1年，这可能导致了我们患者组中出现良好的反应模式。
