Application Of Antiepileptic Drugs In Children With Subclinical Epileptiform Discharges,A Prospective Cohort Study

Objective: to observe the effects of antiepileptic drugs(AEDs)on epileptic seizure,epileptic discharges and cognition in children with subclinical epileptiform discharges(SEDs).Methods: Children with SEDs who met the inclusion criteria treated in Children’s hospital of Chongqing Medical University rehabilitation clinic from Sep.2016 to Sep.2017 were selected as research objects.They were distributed in the experimental group and the control group according to the wishes of their families.All the children in the groups received front line therapy,which includes medication and(or)corresponding comprehensive rehabilitation treatments according to their own diseases(except for the rehabilitation treatments that may induce seizures or stimulate the brain).The children in the experimental group were treated with AEDs according to their EEG with the consent of their families.Each child was followed for one year in the way of giving first place to regular outpatient reexamination and making telephone contacting subsidiary.All the children made the examinations every six months,including EEG in the sleeping and awaking state,the Gesell development schedule(GDS),Wechsler Intelligence Scale for Children Revised in China(WISC-RC),and so on.Relevant data were collected and analyzed.Results: Follow-up: there were 52 children had been followed in the experimental group,while 36 children had been followed in the control group.Epilepsy seizures: In the experimental group 1 child(1.92%)had seizures while 51(98.08%)didn’t;in the control group the data were 3(8.33%)and 33(91.67%)respectively,there was no statistical significance in data difference between the two groups(P>0.05).Discharges in EEG: The experimental group got the effective rate of 55.80%(29/52),and the control group 33.33%(12/36),there was significance difference between the two groups(P<0.05).Cognition: The evaluation results of Gesell showed that after one year of treatment with AEDs,children in the experimental group had significant improvement in terms of individual-social behavior quotient,adaptive behavior quotient,gross motor developmental quotient,fine motor developmental quotient and language developmental quotient,there was statistical significance in the difference(P<0.05),while children in the control group became worse after treatment,but there was no statistical significance in the difference(P>0.05).Before treatment,there was no statistical significance in the difference of Gesell score between the two groups(P>0.05).After treatment,the Gesell scores in the experimental group were improved in terms of adaptive behavior quotient and gross motor developmental quotient by comparing with that in the control group,and there was statistical significance in the difference(P<0.05).As for the results of WISC,there was no significant difference in scores between the two groups before and after treatment(P>0.05)).Conclusion: AEDs can reduce epileptiform discharge and improve cognition in children with clinical epileptiform discharge and cognitive development disorder(such as ADHD,ASD,etc.),and further follow-up and study are needed to investigate the effect of AEDs on clinical onsets.