ANTIEPILEPTIC DRUG-RELATED COGNITIVE COMPLAINTS IN SEIZURE-FREE CHILDREN WITH EPILEPSY BEFORE AND AFTER DRUG DISCONTINUATION

The cognitive complaints reported by children and their parents, as su bjectively associated with antiepileptic drug (AED) treatment, were ev aluated in seizure-free children before and after drug discontinuation . The aim of the design was to isolate the cognitive side effects of A EDs from other factors, such as the effect of seizures. Our inventory explored the following areas: ''alertness,'' ''concentration,'' ''acti vation/ tiredness,'' ''memory,'' ''drowsiness,'' ''depression,'' ''agg ressiveness,'' and ''hyperactivity,'' using a 5-point Likert scaling p rocedure. One hundred two eligible patients were selected, each matche d with a healthy control and assessed when still on antiepileptic medi cation. All children were seizure free for at least 1 year. The medica tion was then discontinued gradually over a 3-month period. Four month s after the children were completely medication free, a second assessm ent 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 con trols, and only showed improvement after drug discontinuation for comp laints about ''tiredness.'' Parents of the children with epilepsy repo rted significant improvement in all areas related to ''alertness and a ctivation'' after discontinuation of the drugs. The finding that only a limited number of children have cognitive complaints, both when stil l on AEDs and after discontinuation, may be in line with the reports t hat the major factor contributing to quality of life is whether patien ts 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 fav orable pattern of response in our patient group.