David W. Loring, Ph.D.
Conclusions
There are many methodological limitations in the literature of AED effects in children using older treatment options that have prevented firm conclusions from being drawn, and many older studies have relied solely on IQ, which tends to be an insensitive measure to all but the most significant neuropsychological impairment (Lezak et al., 2004). In addition, no comparative randomized, controlled trials have been conducted in children using newer AEDs available in the United States. The most recent generation of AEDs tend to have more favorable cognitive profiles than older treatment options, although even newer AEDs with little or no consistent neuropsychological side effects may not be completely benign cognitively. Whether relatively small cognitive effects result in cumulative neuropsychological difficulty or decreased academic performance in children has not been properly investigated and is largely unknown. There is a critical need for appropriate prospective long-term studies of AEDs and cognitions in different applications to determine which drugs and which factors may affect school performance and social adjustment during the school years. Treating children with AEDs associated with better neuropsychological outcomes will maximize school performance, decrease the need for special services in school, and increase quality of life for both patients and their families.
Dr. Loring is professor in the departments of neurology and clinical health psychology at the University of Florida.
References
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