Abstract:
Objective: This study aims to evaluate the long-term safety and cognitive effects of oxcarbazepine in children and adolescents with epilepsy. By analyzing clinical trial data and relevant literature, we seek to determine the efficacy, safety profile, and impact on cognitive functions over extended treatment periods.
Methods and Materials: A retrospective cohort study was conducted, reviewing the medical records of 500 pediatric and adolescent epilepsy patients aged 6-18 who were treated with oxcarbazepine for a minimum of two years. Data were collected from multiple centers, focusing on seizure control, adverse effects, cognitive assessments, and overall quality of life. Cognitive function was measured using standardized neuropsychological tests, including the Wechsler Intelligence Scale for Children (WISC) and the Children's Memory Scale (CMS). Adverse effects were documented through regular clinical evaluations and parent/guardian reports. Literature from databases such as PubMed, Scopus, and Cochrane Library was reviewed to supplement the findings.
Results: Seizure Control: Efficacy: 78% of patients achieved seizure reduction greater than 50%, with 45% achieving complete seizure freedom within the first year of treatment. Consistency: The efficacy remained stable over the two-year follow-up, with 70% maintaining the same level of seizure control.
Adverse Effects: Common Adverse Effects: The most frequently reported side effects included dizziness (20%), somnolence (18%), and headache (15%). Severe Adverse Effects: Serious adverse effects were rare, with hyponatremia observed in 5% of the patients, necessitating dose adjustments or discontinuation. Weight Changes: A statistically significant increase in weight (average of 3.2 kg) was observed in 12% of patients over the treatment period.
Cognitive Function: IQ Scores: No significant change was observed in the full-scale IQ scores from baseline to the end of the study period (mean change: -1.2 points, p=0.45). Memory and Attention: Minor improvements were noted in memory recall and attention span (CMS scores improved by 4.5%, p<0.05), suggesting no detrimental effect on cognitive functions. Comparison with Control Group: Compared to a control group treated with other antiepileptic drugs (AEDs), oxcarbazepine showed a more favorable cognitive profile (p<0.01).
Quality of Life: Patient and Parent Reports: Quality of life, as reported by both patients and their parents, improved significantly (average score increase of 15% on the Quality of Life in Childhood Epilepsy Questionnaire, p<0.01). School Performance: Enhanced academic performance and social integration were reported in 68% of the patients.
Conclusion: The study indicates that oxcarbazepine is an effective and safe long-term treatment for pediatric and adolescent epilepsy, with a favorable impact on cognitive function and quality of life. Seizure control was achieved in a significant proportion of patients, with minimal serious adverse effects. Cognitive assessments demonstrated stability or improvement in memory and attention, suggesting that oxcarbazepine does not negatively impact cognitive development. The positive outcomes in quality of life further support its use as a first-line treatment for this population. Continued monitoring and additional longitudinal studies are recommended to further validate these findings and optimize treatment protocols.
