Seizure Disorders and the Effects of Antiepileptic Medications on Cognitive-Communicative Function

Abstract

Purpose Review effects of epilepsy and its treatment on cognitive-communicative function. Method We searched PubMed and extracted relevant information. Results Epilepsy is a disorder characterized by recurrent unprovoked seizures. Epilepsy is commonly associated with cognitive disturbances in between seizures, most commonly memory dysfunction. Other cognitive disturbances may be seen, particularly auditory naming when epilepsy starts in the dominant temporal lobe. While control of seizures is expected to improve the cognitive consequences, antiepileptic drugs themselves may be associated with cognitive dysfunction. Among the old generation of antiepileptic drugs, the sedating medications phenobarbital and benzodiazepines have the most negative impact on cognitive function. However, carbamazepine, phenytoin, and valproate may also adversely affect attention and memory. The newer antiepileptic drugs lamotrigine, gabapentin, and levetiracetam (LEV) are less likely to affect cognition than carbamazepine. Another new antiepileptic drug, topiramate, is associated with considerable adverse effects on attention, concentration, memory, executive function, and verbal fluency. Word finding difficulties are a common adverse effect, to the point that some patients can develop a nonfluent aphasia. Levetiracetam (LEV), on the other hand, has been reported to improve verbal fluency in patients with partial epilepsy and language dysfunction. Conclusions Both epilepsy and its treatment may adversely affect cognitive-communicative function.