Cognitive Function and Educational Achievement in Children with Focal Epilepsy and Long-Term Therapy with Oxcarbazepine

Purpose: In this study, the cognitive function of patients with simple focal and benign childhood epilepsy with centrotemporal spikes and long-term oxcarbazepine therapy was tested by psychometric tests. Materials and Methods: During the period 1998–2003, we tested 43 patients aged 5 8/12–13 9/12 years (mean age at the onset of the therapy 9 2/12 years) and 45 healthy controls, aged 6–14 years. All of them underwent a complete neurological examination, EEG, brain MRI, psychometric tests (WISC-III, Bender-Santucci, Illinois test) before treatment. The reexamination took place after 12 and 24 months of therapy. No important side effects were observed. The EEGs showed focal abnormalities, which depended on the type of the epilepsy. The control EEGs were normal. Results: The psychometric test did not show a statistically significant difference in the intelligence quotient among the patients before the administration of the drug and the controls, which demonstrates the important similarity of the samples. In 6/43 patients and 3/45 controls, learning disabilities were observed. The difficulties were localized in the ability for mathematical thought, logical abstractive thinking, long-term and visual short-term memory. The intelligence quotient was normal. The patient group, examined 10–12 months after drug administration, showed a significant improvement on the ability to logical abstractive thinking and verbal comprehension. This small improvement is explained by the cognitive maturation, which is accomplished through each child's biological development. 24 months after the administration of the therapy an improvement on the long-term memory and visuomotor coordination was observed, which shows that the drug did not influence the ability for long-term acquisition. Conclusion: Our results showed that the cognitive functions, which are directly connected to the children's performance at school, are not influenced as a rule.