Service de Pédiatrie, Hôpital Mère-Enfant, 44093 Nantes
Cognitive and behavioral impairment are more frequent in epileptic children than in the general population. Respective role of seizures, cerebral lesion and antiepileptic drugs is difficult to identify, especially in severe epilepsy. Nevertheless, the possible negative effect of treatment on cognitive performance is a constant preoccupation for parents.
Despite numerous clinical investigations this remains questionable. Methodological difficulties could in part explain contradictory results obtained for a given drug.
The most recent data suggest that antiepileptic drugs used in monotherapy (with the exception of phenobarbital) do not have clear effect on cognitive and behavioral development in children. This does not exclude individual sensibility observed in clinical practice. Identifying clinical risk factors for significant cognitive adverse effects may help prescription. For the new antiepileptic drugs few additional studies are needed to define cognitive and behavioral profiles.