Abstract
Cognitive decline in children with seizure disorders is due to several factors, one being the choice of anticonvulsant and total anticonvulsant exposure. This paper reviews research investigating cognitive effects associated with “older” anticonvulsant medications (i.e., phenobarbital, phenytoin, carbamazepine, and valproate) prescribed as monotherapy. A number of cognitive difficulties such as intellectual decline, mild memory loss, visual-motor impairment, and psychomotor slowing have been associated with these medications. Each study included in this review is assessed in terms of the appropriateness of study design and ability of the reader to draw clear conclusions about the cognitive effects associated with the anticonvulsant under investigation. The review also includes a synopsis of the myriad of methodological difficulties that plague this body of literature. Conclusions that can be drawn from the existing literature are delineated, and future directions for research are suggested.
Keywords: phenobarbital, valproate, carbamazepine, phenytoin, anticonvulsant, antiepileptic, epilepsy, cognitive effects
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