Cumulative effects of antiseizure medication on intelligence in children with focal epilepsy
Carmen H. Stevering, Herm J. Lamberink, Julie Woodfield, Monique van Schooneveld, Willem M. Otte, Richard F.M. Chin, Mark E. Bastin, Karin Geleijns, Kees P.J. Braun
Epileptic Disord. 2022 Oct 1;24(5):1-12.
doi: 10.1684/epd.2022.1467.
Hot off the press - Many caregivers are concerned about the potential long-term effects of using antiseizure medications and how it may affect their children’s intelligence.
This #retrospective study by Stevering et al. (Oct. 2022) confirmed a significant negative relation between ASM load and total intelligence quotient (IQ), showing a decrease of 1.2 total IQ per medication year (95% CI: -2.0 to -0.3).
The study enrolled 59 pediatric patients with focal epilepsy who all underwent neuropsychological assessment and at a single center. The median medication load was 5.3 medication years (range: 2.0-11.1 years), mean total IQ was 77.4±18.9. The relation between ASM load and total IQ was calculated and corrected for epilepsy-related confounders, including age at the first treatment, etiology, maximum seizure frequency, and duration of epilepsy.
Noteworthy, the study found no evidence that a change in brain volume would correlate with the total IQ decrease associated with the use of ASMs. Despite the negative association between ASM load and total IQ, it is worth considering that the seizure-related benefits associated with an effective ASM treatment in many situations would outweigh the risk factors. #Prospective, long-term follow-up studies are needed to confirm these findings.