Juvenile Myoclonic Epilepsy in Children and Adolescents: The Effect of Antiseizure Medications on Cognitive Functions

Abstract

Objective

The objective of this study was to investigate the effect of antiseizure medications (ASMs) on cognitive abilities in children and adolescent patients newly diagnosed with Juvenile Myoclonic Epilepsy (JME). Additionally, the study compared cognitive abilities between newly diagnosed JME patients and healthy controls.

Methods

38 patients newly diagnosed with JME based on clinical history and electroencephalographic findings (mean age 14.85 ± 1.80) and 30 healthy control participants (mean age 14.07 ± 1.86) were included in our study. In the JME group, there were 71.1% females and 28.9% males, whereas in the control group there were 60% females and 40% males. Bourdon Attention Test and Wechsler Intelligence Scales for Children–Revised (WISC-R) were performed to measure the cognitive abilities of the patient and control groups. In the JME group, the tests were performed before and 12 months after antiseizure medications were started. The patients’ clinical, laboratory, radiologic, and electroencephalographic (EEG) data, as well as their antiseizure medication use and treatment compliance were recorded and collected through our hospital database system during the outpatient clinic visits.

Results

The results showed a very high and positive correlation between WISC-R–Pre and WISC-R–Post test scores in the patient group, and this was statistically significant (P =0.001). Although the WISC-R–Pre test average was 89.89 ± 20.28, the WISC-R–Post average was 92.66 ± 21.79. This increase was found to be statistically significant (P =0.023). Although the average score of the Bourdon-Pre test was 310.84 ± 104.84, the Bourdon-Post score was found to be 272.79 ± 75.616. This decrease was not found to be statistically significant (P = 0.063). Although the average number of seizures per year was 6.78 before treatment, it decreased to 2.52 after treatment. This difference was found to be statistically significant (P =0.001). The strongest significance with the lowest P value (0.003) was observed in the levetiracetam group. In the patient group, a positive correlation was found between the number of seizures and WISC-R–Post test scores and this was statistically significant (P =0.05).

Conclusions

No significant difference was found between the newly diagnosed JME patients and the healthy control group in terms of intelligence level and attention performance. However, it was concluded that the antiseizure medications initiated in the patient group had a positive effect on cognitive function. In addition, a statistically significant positive correlation was detected between the decrease in the number of seizures after medication and the WISC-R–Post test, demonstrating the positive effect of drug treatment on cognitive functions.