Assessment Of Phenobarbital’s Efficacy And Impact On Cognitive Function Of Patients With Epilepsy From Some Rural Areas In North China

Purpose:Investigate and evaluate phenobarbital’s efficacy, adverse reaction and impact on cognitive function of enrolled patients from some rural areas in Jilin Province (Dongfeng, Yitong and Meihekou).Method:1. Patients with eclamptic epilepcy were screened and selected from Dongfeng, Yitong and meihekou under the coordination of Health Department of Disease Control Department. After enrollment, free phenobarbital were provided according to its instruction. Regular follow-up and management for the patients were implemented. The reduction in frequency of attacks in one year was used as the Response Evaluation Criteria.2. From the above three areas each,10untreated epileptic (including newly diagnosed and those had never took antiepileptic drugs2years before enrolled) were randomly selected as the study group, Then10healthy subjects were chosen as the control group in the same village in the same area respectively.In baseline phase, both the study and control group’s cognitive function were evaluated with four neuropsychologic tests including:Auditory Verbal Learning Test (AVLT), Digit Span Test (DST), Verbal Fluency Test (VFT) and Digital Cancellation Test (DCT). The study group were treated with phenobarbital for12months and cognitive function tests were implemented separately at the3rd month,6th month and12th month. Finally the scores were analyzied by Gnu R.Result:1. Totally829patients were enrolled in the three areas,460males and369females. No treatment and irregular treatment patients accounted for42.1%of them. Nearly16.8%of them had never took treatement.Efficacy assessment showed, there were596patients completing six months’treatment, of whom227seizured free at the end,79patients gained their attack frequencies decreased3/4, compared with baseline, so the total effective rate was51.4%.509patients completed one year’s treatment, and the total effective rate was61.3%.276patients completed2years’treatment, the total effective rate was68.2%.61patients completed full treatment of three years, the effective rate was70.5%. The shorter of the treatment duration, the better of the efficacy. The most common adverse reactions were drowsiness, lethargy. No serious adverse events were found.2. Comparing with control group, no treatment patients got lower score in AVLT, DST, VFT and DCT, indicating cognitive fuction disorder (p<0.01). In the study group, no significant difference was found between the AVLT scores at the3rd month and beseline (p>0.05); the scores decreased at the6th month (p<0.01),while at the12th month, the AVLT scores decreased more significantly (p<0.01). Comparing with the baseline, no difference was found about the DST, VFT and DCT in study group (p>0.05)Conclusion:1. Phenobarbital is effective for epilepsy. First episode at early age and short duration ones had better outcome after drug treatment, comparing with the elderly and longer duration ones. Adverse reactions were mild, and gradually decreased with the extension of medication period, having little impact on life quality.2. No treatment epileptic patients had a wide range of cognitive dysfunction, comparing with control group. Phenobarbital treatment may cause cognitive dysfunction to some extent.