Children (12–18 Years Age) of Women with Epilepsy Have Lower Intelligence, Attention, and Memory: Observations from the Kerala Registry of Epilepsy and Pregnancy

Objective: We aimed to study the cognitive outcome of 12- to 18-year old children of women with epilepsy (WWE).

Methods: Children of WWE (12–18 years) under follow-up in Kerala Registry of Epilepsy and pregnancy (n = 86) were evaluated with Wisconsin Card Sorting Test (WCST), trail making test (TMT), Rey auditory verbal learning test (RAVLT), and Rey–Osterrieth complex figure test (ROCFT).

Results: There were 41 women with generalized epilepsy (47.7%) and 45 with localization-related epilepsy (52.3%). Antiepileptic drugs (AEDs) exposure was as follows: carbamazepine (26), valproate (21), phenytoin (five), phenobarbital (three), polytherapy (25), and six were unexposed. The full-scale IQ (FSIQ) and higher order executive functioning of children of these 86 WWE showed significant difference with AED exposure. The FSIQ mean ± SD for different AEDs were phenobarbital: (73.6 ± 14), phenytoin: (87.7 ± 22.1), carbamazepine: (96.4 ± 8.2), valproate: (93.6 ± 13.6). The FSIQ for those exposed to phenobarbital was significantly (p = 0.045) lower than others, whereas those children unexposed to AEDs had high FSIQ scores (mean = 97.92, SD = 10.72; p = 0.028). Higher order executive functioning, specifically the ability to maintain and shift set was found to be low in children exposed to phenobarbital and valproate monotherapy compared with no AED exposure (p = 0.049).

Conclusion: IQ and higher order executive functioning were significantly lower for 12- to 18- year-old children of WWE exposed to different AEDs when compared with nonexposed children. Thus, antenatal AED exposure is an important predictor of low FSIQ and higher order executive functioning.