J Clin Neurol.  2020 Jan;16(1):46-52. 10.3988/jcn.2020.16.1.46.

Effects of Lamotrigine on Problem-Solving Abilities in Newly Diagnosed Pediatric Patients with Epilepsy

• Lee SH
• Kim SJ

• KMID: 2467783
• DOI: http://doi.org/10.3988/jcn.2020.16.1.46

Abstract

BACKGROUND AND PURPOSE
This study aimed to determine the effects of lamotrigine (LTG) on language unction, including problem-solving abilities, in newly diagnosed pediatric epileptic patients.
METHODS
This study included 112 newly diagnosed epileptic patients treated with LTG [69 males and 43 females aged 9.6±2.7 years (mean±SD)]. Repeated neurologic examinations, electroencephalography, neuroimaging studies, and standard language tests including the Test of Problem Solving (TOPS), mean length of utterance in words (MLU-w), Receptive and Expressive Vocabulary Test (REVT), and Urimal Test of Articulation and Phonology were performed before and after initiating LTG treatment. The starting LTG dosage was 1 mg/kg/day (maximum: 25 mg/day) for the first 14 days, which was increased to 2 mg/kg/day for the subsequent 14 days and then up to 7 mg/kg/day (or 200 mg/day) for maintenance.
RESULTS
Problem-solving skills as assessed by TOPS scores significantly improved after initiating LTG treatment (33.5±14.5 vs. 35.7±14.25, p < 0.01). Scores in the "determining causes" category (11.9±4.7 vs. 12.9±4.8, p < 0.01), "making inferences" category (12.9±6.2 vs. 13.6±6.0, p < 0.05), and "predicting" category (8.9±5.4 vs. 9.7±5.6, p < 0.01) significantly improved after LTG treatment. The MLU-w score did not decrease after LTG treatment (4.7±1.9 vs. 5.0±2.1). There was a significant improvement in receptive language function as assessed using the REVT score (9.4±3.4 years vs. 9.9±3.3 years, p < 0.01). Precise articulation also improved after initiating LTG treatment (97.8% vs. 98.5%).
CONCLUSIONS
Language function including problem-solving skills improved after LTG treatment, suggesting that LTG can be administered without causing significant negative effects on language function in pediatric patients.

Keyword

lamotrigine; problem-solving ability; language function; epilepsy; pediatric patients

MeSH Terms

Electroencephalography
Epilepsy*
Female
Humans
Language Tests
Male
Neuroimaging
Neurologic Examination
Problem Solving

Figure

• 

  Fig. 1 Score difference in the “determining causes” category of the Test of Problem Solving. Data are mean and SD values. LTG: lamotrigine.

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