Comparative evaluation of levetiracetam and valproic acid as monotherapy on cognitive impairment in patients of epilepsy

Shreshth Khanna; Suman Bala; Yashpal Singh; Taruna Sharma; Juhi Kalra; D. C. Dhasmana; Saurabh Kohli

doi:10.18203/2319-2003.ijbcp20191098

Authors

Shreshth Khanna Department of Pharmacology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
Suman Bala Department of Pharmacology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
Yashpal Singh Department of Neurology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
Taruna Sharma Department of Pharmacology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
Juhi Kalra Department of Pharmacology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
D. C. Dhasmana Department of Pharmacology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
Saurabh Kohli Department of Pharmacology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India

DOI:

https://doi.org/10.18203/2319-2003.ijbcp20191098

Keywords:

Cognitive impairment, Epilepsy, MMSE, MoCA

Abstract

Background: Cognitive decline with AEDs (Anti-epileptic drugs) is associated with learning and memory deficits especially in the younger age group. The data regarding the impact of levetiracetam and valproic acid as monotherapy on cognition in epileptic patients is scarce. The present study was done for evaluation of cognitive decline associated with the use of AEDs.

Methods: Present study was a prospective study on 60 patients on AEDs for a period of 12 weeks. Patients were enrolled from the Department of Neurology, Swami Rama Himalayan University, Dehradun, Uttarakhand, India and divided into group A (levetiracetam) and group B (valproic acid) with 30 patients in each group. Permission from the institutional ethics committee and written informed consent was taken from all the patients. They were analyzed for cognitive impairment using MMSE and MoCA scales at baseline and 12 weeks.

Results: The mean duration of disease was 2.13±1.1 years and 2.08±1.1 years and mean age of the patients was 14.67±1.9 years in group A and 16.20±1.6 years in group B. GTCS was present in 31 patients (52%) followed by partial seizures in 29 patients (48%). The mean change in the MMSE scores from baseline to 12 weeks was significant in group A 1.30±1.1 (p value <0.05) and change group B was -0.20±1.4 not statistically significant. The mean change was observed in MoCA scores from baseline to 12 weeks was significant in both groups A and B by 1.17±1.1 and -0.70±1.1 respectively (P value <0.05).

Conclusions: Patients on levetiracetam showed cognitive improvement, whereas patients on valproic acid showed a decline in the MMSE and MoCA scores.

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