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Barbiturate anticonvulsants: a neuropsychological and quantitative electroencephalographic study
J Willis1, A Nelson, F W Black
1Department of Psychiatry and Neurology, Tulane University Medical School, New Orleans, LA 70112, USA.
Insights
Barbiturate anticonvulsants like phenobarbital and mephobarbital did not alter quantitative electroencephalography (EEG) in epileptic children. Limited neuropsychological effects were observed, primarily on the Stroop Test, with some behavioral changes reported.
Area of Science:
- Pediatric Neurology
- Neuropsychology
- Pharmacology
Background:
- Epilepsy management often involves barbiturate anticonvulsants.
- Understanding the impact of these medications on cognitive function and brain activity is crucial for pediatric patients.
Purpose of the Study:
- To investigate the effects of phenobarbital and mephobarbital on quantitative electroencephalography (EEG) and neuropsychological test performance in epileptic children.
- To compare these effects with those in a control group.
Main Methods:
- Quantitative EEG and a comprehensive battery of neuropsychological tests were administered to 11 epileptic children (aged 7-14) on and off barbiturate anticonvulsants.
- Performance was compared to 13 age- and IQ-matched controls.
Main Results:
- No significant differences were found in quantitative EEG power across frequency bands between on- and off-drug conditions.
- The only significant neuropsychological difference compared to controls was on the Stroop Test.
- Parents reported behavioral changes (irritability, oppositional attitude, overactivity) in 6 of 11 children, with mephobarbital causing fewer issues than phenobarbital.
Conclusions:
- Barbiturate anticonvulsants demonstrate no discernible effect on quantitative EEG in school-aged epileptic children.
- These medications have limited neuropsychological impact, with subtle behavioral changes being the most notable side effect.
- Mephobarbital may be associated with milder behavioral issues compared to phenobarbital.
Abstract:
We studied 11 epileptic children aged 7 to 14 years with quantitative electroencephalographic (EEG) and neuropsychological tests, both on and off the barbiturate anticonvulsants phenobarbital and mephobarbital, comparing them to 13 controls matched for age and IQ who received testing at similar intervals. Neuropsychological tests employed were the Wechsler Intelligence Scale for Children-Revised (WISC-R), Bender-Gestalt, controlled oral word association test (COWAT), selected subtests of the Wechsler Memory Scale-Revised, Purdue Peg Board, Stroop Test, Trail Making Test, Wide Range Achievement Test-Revised, and Achenbach Behavior Rating Scale. There was no difference between on- and off-drug quantitative EEG in percentage power of any frequency band between 0.6 and 32 Hz. Neuropsychological data from all 11 subjects were analyzed with a two-factor analysis of variance with repeated measures on the time factor. The only difference from controls was on the Stroop Test. Parents reported clear behavioral changes in 6 of 11 subjects, but in 4 of these children the behavioral changes were sufficiently mild that parents chose to continue the barbiturate anticonvulsants: irritability, oppositional attitude, and overactivity were described. Mephobarbital was reported by parents to cause less severe problems than phenobarbital in subjects who had taken both barbiturate anticonvulsants. Barbiturate anticonvulsants have no effect on quantitative EEG and limited effects on neuropsychological tests in school-aged children.