A Study In Cognition Of School-age Children With Epilepsy Treated By The Phenobarbital And An Analysis Of Related Factors In Those Cognitions

Objective:To evaluate and compare cognitive conditions between the epileptic school-age children without and with treatment 6 months, using Wechsler Intelligence Scales for Children (WISC) and analyzing related factors.We expected to supply evidences of the treatment for children with epilepsy in rural areas through our research.Methods:WISC was tested in 52 epileptic school-age children who received Phenobarbital treatment before and after 6 month in Luoping and Lufeng in Yunnan; some details such as the age, gender, educational background, age of onset, epilepsy duration, seizures frequency, PB dose, seizure control situation were recorded; cognitive status with and without treatment were compared; influencing factors that maybe result in cognitive impairment were analyzed and screened out.Results:1. Seizure-controlled condition after 6 months treatment:A markedly effective case was 37, accounted for 71.2%; a normal effective case was 8, accounted for 15.4%; an invalid case was 7, accounted for 13.5%.2. Comparing IQ before and after treatment with PB:VIQ decreased and PIQ increased after treatment than before; no significant differences were observed in FSIQ between before and after treatment. 3. Comparing Sub-test items before and after treatment:Arithmetic and Digit Span Scores decreased after treatment; Block Design, Object Assembly and Digit Symbol increased after treatment.4. Comparing IQ among groups with different seizure-controlled condition:there is statistic significance among VIQ, PIQ and FSIQ, the comparison of test score is:invalid group< normal effective group< markedly effective group.5. Correlation analysis shows that:epilepsy duration and seizures frequency negatively correlated to IQ (VIQ, PIQ and FSIQ); Educational background and age of onset positively correlated to IQ, the age and the gender didn't have correlation with IQ, the same as after 6 months treatment of PB. Additionally, seizure-controlled rate positively and drug dose does not correlated to IQ.6. Multiple stepwise regression analysis shows that the age of onset and epilepsy duration may be major risk factors influenced FSIQ.Conclusion:1.PB treatment is significantly available to control generalized tonic-clinic epilepsy in school-age children.2. After 6 months treatment of PB, epileptic children's VIQ score decreased, PIQ score increased and FSIQ have no change 3. After 6 months treatment of PB, average scores of Arithmetic and Digit Span decreased, that of Block Design, Object Assembly and Digit Symbol increased. 4. There are sharply different scores in IQ test:effective group> normal effective group> invalid group. 5. Whether before or after 6 months treatment, IQ(VIQ,PIQ,FSIQ) negatively correlated to epilepsy duration and frequency of seizures, and positively correlated to age of onset and seizure control rate,non-correlated to PB dose. 6. The age of onset and epilepsy duration are major risk factors may contribute to FSIQ.