Cognitive Effects Of Anti-Epileptic Drugs In Nigerians With Epilepsy

Abstract

Background Epilepsy is particularly highly prevalent in developing African countries and has been associated with cognitive disturbances, but more importantly is the contribution of the anti-epileptic drugs (AEDs). Objective This study aimed at comparing the effects of AEDs on the cognitive functions of Nigerian epileptic patients. Methods This is a prospective study of 55 consecutive patients with epilepsy, aged 14 years and above, over a two year period (October 2000 to October 2002), recruited from the Neurology Clinic of the University Teaching Hospital, Benin City, Nigeria. Anti-epileptic treatment with either carbamazepine (19 patients), phenytoin (18 patients), or phenobarbitone (18 patients) which was randomly assigned constituted the interventional measure. Cognitive testing, using the Iron Psychology (FePsy) a computerized neuro-psychological test battery, measured the visual and auditory reaction times, the continuous performance test and the recognition memory test to assess the mental speed, attention and memory respectively. Results The effect of the individual drug on cognitive performance revealed significant impairment of mental speed (p 0.05). Carbamazepine did not significantly affect the verbal (Words section) memory scores (p>0.05) implying better performance in tasks of verbal memory (p Introduction La prevalence de l\'epilepsie est elevee en Afrique de meme que les troubles cognitifs associes a l\'utilisation des antiepileptiques (AEDs). But Le but de l\'etude est de comparer les effets des AEDs sur les fonctions cognitives d\'une population epileptique nigeriane. Methodes L\'etude prospective, randomizee, concerne 55 patients epileptiques âges de 14 ans et plus, etudies sur une periode de 2 ans (octobre 2000 a octobre 2002) et recrutes dans le service de neurologie du CHU de Benin City. Le traitement etait soit la carbamazepine, (19 patients) soit la phenitoine (18 patients), soit du phenobarbital (18 patients) Les tests cognitifs utilisant le Iron Psychology (FePsy), tests psychologiques, ont mesure les temps de reaction auditif et visuels, les tests de performance de la memoire mentale, de l\'attention et de la memoire. Resultats Chacun des medicaments a entraine une perturbation de la vivacite mentale (p 0.05). La carbamazepine n\'a pas affecte de maniere significative la memoire verbale (mots) (p > 0.05). Tous les autres antiepileptiques ont reduit les capacites d\'attention des patients ( p Keywords : Africa, Anti-epileptic drugs, Epilepsy, Memory, Mental speed, Nigeria, Afrique, Antiepileptiques, Epilepsie, Memoire. Nigeria, Tests psychologiques African Journal of Neurological Sciences Vol. 24 (1) 2005: pp. 18-24