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Neurocognitive effects of phenobarbital discontinuation in epileptic children

Seyed Hassan Tonekaboni1, Narguess Beyraghi, Hosseinzadeh Sahar Tahbaz

  • 1Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Epilepsy & Behavior : E&B
|November 4, 2005
PubMed

Insights

Stopping phenobarbital (PB) therapy in children with epilepsy improved cognitive function, particularly nonverbal skills. This suggests PB can negatively impact cognition in pediatric patients.

Area of Science:

  • Pediatric Neurology
  • Neuropsychology

Background:

  • Phenobarbital (PB) is a globally prevalent antiepileptic drug.
  • Concerns exist regarding PB's potential adverse cognitive and behavioral effects.

Purpose of the Study:

  • To assess if discontinuing PB in children with epilepsy leads to cognitive function improvements.
  • To evaluate the impact of PB cessation on neuropsychiatric performance.

Main Methods:

  • Two groups of children (6-12 years old) with epilepsy, seizure-free for at least 2 years on PB monotherapy, were studied.
  • The case group (n=24) discontinued PB, while the control group (n=21) continued PB therapy.
  • Neuropsychiatric performance was assessed using the Wechsler Intelligence Scale for Children-Revised (WISC-R) over two 7-month periods.

Main Results:

  • Total IQ scores significantly increased in the case group compared to the control group (P = 0.027).
  • Cognitive improvements were primarily observed in performance (nonverbal) aspects.
  • Verbal cognitive function remained largely unchanged following PB discontinuation.

Conclusions:

  • Phenobarbital therapy appears to negatively affect cognitive function in children.
  • Discontinuation of PB can lead to a reduction in performance (nonverbal) deficits.
  • These findings support the consideration of PB cessation for improving cognitive outcomes in pediatric epilepsy patients.
Abstract

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