New Anti-epileptic Drugs On Cognitive Function

Objective: Epilepsy is one of the nervous system diseases, in recent years, scholars at home and abroad study found that epilepsy patients in the cognitive impairment of its common incidence of 30% -40%. Oral anti-epileptic drugs is the primary means of treatment of epilepsy, anti-epileptic drug in controlling seizures, reducing the secondary, while cognitive impairment can also lead to new or other types of cognitive dysfunction, long-term oral anti-epileptic drugs great damage to cognitive function in interference with the daily life of epilepsy patients, the antiepileptic drugs on cognitive function of a growing cause for concern. The traditional antiepileptic drugs (AEDs) on cognitive function of a large number of studies have reported a wider clinical application of the current new antiepileptic drugs on cognitive function study on the impact of a relatively small, this study further evaluation of new anti - the application of epilepsy drugs lamotrigine more (LTG), topiramate (TPM), oxcarbazepine (OXC) on cognitive function in patients with epilepsy and thus guide the clinical choice of medication, avoiding or reducing its impact on patients with cognitive function, to improve their quality of life.Methods: Of August 2007 to April 2008, at the First Clinical Hospital of Jilin University Department of Neurology, the epilepsy out-patient clinic specifically in patients with disease, clinical diagnosis of epilepsy (seizure type is partial or not made a companion with a comprehensive attack), diagnosis based on Clinical manifestations and EEG changes (except for other mental diseases of the nervous system), at the same time need to meet the following criteria: a history of epilepsy <2 years; the age of 16-50 years of age; course of 2 years; not the law of the application of AEDs treatment; attack frequency of 1 year >2 times. Will be divided into four groups of patients given anti-epileptic drugs, single drug treatment, 20 cases of patients with TPM group, LTG group 20 cases of patients, OXC group of 18 cases of patients, the traditional group of 20 cases of anti-epileptic drugs (of which 10 cases of carbamazepine , 10 cases of valproic acid) as a control in each group before treatment of patients with cognitive evaluation of Montreal (including the turn of the connection test, depending on the structure of skills, naming, Shun back digit span, digit span, awareness, word fluency, abstraction, delayed memory, orientation), to give each group of patients with antiepileptic drug therapy, medication for 6 months after the re-evaluation of cognitive function, and compared to before treatment.Results: Four patients in age, gender, disease duration, attack frequency, clinical type and so no significant difference (P>0.05), before administration of the neuropsychological evaluation of patients with no significant difference between scores. In this study, CBZ, VAP, taking 6 months after the evaluation of patients with memory decline in scores than before treatment, with significant difference (P<0.05), meanwhile neuropsychological evaluation after treatment decreased the total score, with a significant difference (P<0.05). LTG group after treatment compared with the LTG group before treatment evaluation scores increased after treatment, the difference was significant difference (P<0.05), one of the test score increase of memory (P<0.05), the attention of sub-test score increased (P<0.05). TPM medication group scored lower after the evaluation, a significant difference (P<0.05), sub-tests of attention, memory, verbal fluency TPM fraction 3 after treatment than before treatment has declined, and there is significant difference (P<0.05). OXC group after treatment compared with before treatment, no significant difference between the two (P>0.05), one of the test after administration of the average memory score increased, but no significant difference (P>0.05).Conclusions: Lamotrigine can be effective control of epileptic seizures at the same time does not increase the cognitive dysfunction, and cognitive activation of a certain role in improving the performance of the logic of the main memory, delayed memory and computational logic of power. Topiramate can cause cognitive dysfunction in patients with epilepsy, the main function of the performance for the speech impaired, in particular, impaired verbal fluency, slow thinking, difficulty finding words, and in patients with severe cognitive impairment in addition to the above-mentioned performance, but also with severe memory, computing power barriers. Oxcarbazepine for epilepsy patients with memory, attention, and no significant effect on the implementation of capacity, and its impact on cognitive function was not obvious. Group of traditional anti-epileptic drugs (carbamazepine, sodium valproate) can cause cognitive decline in patients, mainly for memory decline in the performance of its attention on the patients, language function, the implementation was not obvious to no effect.Guided by the principles of antiepileptic drugs is to reduce the use of antiepileptic drugs on cognitive function in an effective way to damage. In short, with the development of medicine, biomedical model, in the treatment of diseases at the same time, people, as more and more emphasis on the quality of life of patients improve. Cognitive and behavioral functions of life in patients with epilepsy emerged, and its attention more and more influencing factors, research will continue to deepen.