title: [Epilepsy and cognition: the role of antiepileptic drugs].
abstract: BACKGROUND
  Multiple factors underlie the cognitive changes associated with epilepsy, including the effect of antiepileptic drug (AED) therapy itself. The use of AEDs in the management of epilepsy requires an ongoing risk-benefit analysis that attempts to maximize seizure control while minimizing adverse cognitive side-effects.
  
  
  OBJECTIVE
  This review focuses on the global and specific cognitive effects of the classic and the new AEDs.
  
  
  METHODS
  All of the established AEDs can produce cognitive side effects, which are increased with polypharmacy and with increasing dosage and anticonvulsant blood levels. The main disorders are a diminished reaction and information processing time with alterations affecting memory, attention and language. Further, there is much debate concerning the existence and clinical importance of differential AED cognitive side effects and a large portion of the literature examining the comparative cognitive effects of AEDs is limited by inadequate study designs.
  
  
  CONCLUSIONS
  Cognitive side effects of antiepileptic drugs are common and can negatively affect tolerability, compliance, and long-term retention of the treatment. The role of cognitive side effects should be kept in proper perspective when choosing AED therapy. It is important to be able to recognize early these effects and to put them into perspective as to how they affect our patients.
authors.affiliation: Hospital Infantil Universitario Nino Jesus, 28009 Madrid, Espana.
authors.forename: Juan José
authors.initials: JJ
authors.lastname: García-Peñas
authors.forename: M Concepción
authors.initials: MC
authors.lastname: Fournier-Del Castillo
authors.forename: Jana
authors.initials: J
authors.lastname: Domínguez-Carral
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects* / Q000145:classification / Q000627:therapeutic use; D001288:Attention / Q000187:drug effects; D002648:Child; D002653:Child Behavior Disorders / Q000139:chemically induced* / Q000209:etiology; D003071:Cognition / Q000187:drug effects; D003072:Cognition Disorders / Q000139:chemically induced* / Q000209:etiology; D004357:Drug Synergism; D004827:Epilepsy / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D007806:Language Disorders / Q000139:chemically induced / Q000209:etiology; D007859:Learning Disabilities / Q000139:chemically induced* / Q000209:etiology; D008568:Memory / Q000187:drug effects; D008569:Memory Disorders / Q000139:chemically induced* / Q000209:etiology; D018570:Risk Assessment
chemical_list: D000927:Anticonvulsants