Antiepileptic drug behavioral side effects and baseline hyperactivity in children and adolescents with new onset epilepsy
Antiepileptic drug behavioral side effects and baseline hyperactivity in children and adolescents with new onset epilepsy
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DOI：
10.1111/epi.13946
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发表时间：
2018-01-01
期刊：
影响因子：
5.6
通讯作者：
Modi, Avani C.
中科院分区：
文献类型：
--
作者：
Guilfoyle, Shanna M.;Follansbee-Junger, Katherine;Modi, Avani C.
ObjectiveObjectives研究基线心理功能和抗癫痫药物（AED）的行为副作用在新发癫痫，并确定，年龄，是否基线心理功能预测AED行为副作用1个月后AED initiation.MethodsA回顾性图表审查进行了2011年7月至2014年12月，包括青年新发癫痫。作为常规跨学科护理的一部分，护理人员完成了儿童行为评估系统，第2版：父母评定量表，以报告诊断访视时的基线心理功能，以及儿科癫痫副作用问卷，以确定AED启动后1个月随访诊所访视时的AED行为副作用。结果共纳入380例新发癫痫患者，其中男性年龄8.94 ~ 4.3岁，白人占83.4%，局灶性癫痫占34.8%，全身性癫痫占41.1%，未分类癫痫占23.7%。70%的年轻人有风险或临床上升高的基线心理症状。与青少年（M =12.36 +/- 17.73）相比，儿童（M=25.08 +/- 26.36）具有更大的AED行为副作用，无论是否使用AED。丙戊酸表现出显着更大的行为副作用相比，所有其他AED，左乙拉西坦除外。在两个年龄组中，基线时较高的多动/冲动显著预测AED启动后1个月较高的AED行为副作用。基线心理筛查，特别是多动，可用作AED选择的精确医学工具。
ObjectiveTo examine baseline psychological functioning and antiepileptic drug (AED) behavioral side effects in new onset epilepsy and determine, by age, whether baseline psychological functioning predicts AED behavioral side effects 1month following AED initiation.MethodsA retrospective chart review was conducted between July 2011 and December 2014 that included youths with new onset epilepsy. As part of routine interdisciplinary care, caregivers completed the Behavior Assessment System for Children, 2nd Edition: Parent Rating Scale to report on baseline psychological functioning at the diagnostic visit and the Pediatric Epilepsy Side Effects Questionnaire to identify AED behavioral side effects at the 1-month follow-up clinic visit following AED initiation. Children (age = 2-11years) and adolescents (age = 12-18years) were examined separately.ResultsA total of 380 youths with new onset epilepsy (M-age=8.94.3years; 83.4% Caucasian; 34.8% focal epilepsy, 41.1% generalized epilepsy, 23.7% unclassified epilepsy) were included. Seventy percent of youths had at-risk or clinically elevated baseline psychological symptoms. Children had significantly greater AED behavioral side effects (M=25.08 +/- 26.36) compared to adolescents (M=12.36 +/- 17.73), regardless of AED. Valproic acid demonstrated significantly greater behavioral side effects compared to all other AEDs, with the exception of levetiracetam. Higher hyperactivity/impulsivity at baseline significantly predicted higher AED behavioral side effects 1month after AED initiation in both age groups.SignificanceYounger children seem to be more prone to experience behavioral side effects, and these are likely to be higher if youths with epilepsy have baseline hyperactivity/impulsivity. Baseline psychological screening, specifically hyperactivity, can be used as a precision medicine tool for AED selection.