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KMID : 0380319910480000077
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Journal of Korean Research Institute for Better Living
1991 Volume.48 No. 0 p.77 ~ p.87
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Serum Levels of Anticonvulsants and Mental Symptoms in Epileptic Patients
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Abstract
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Recently with increasing recognition of some of the chronic and neuropathological effects of anticonvulsant therapy and the development of technique for measuring serum anticonvulsant levels, more serious attentin is being derected at the possible role of such therapy in the precipitation of mental symptoms. The author studied 61 epileptic patients attending the neuropsychiatric clinic of Ewha Womans University Hospital to confirm the serum anticonvulsant levels in relation to the clinical symptoms of mental state, seizure control and the sign of toxicity from Jan.1, 1990 to May 31, 1991.
For each category of mental state(psychomotor slowing, intellectual deterioration, psychiatric illness or personality change), the subjects with evidence of impairment had higher concentration of both DPH and PB, CBZ, VPA than those without such impairment.
Those subjects with well controlled seizures had higher concentrations than those with poorly controlled seizures.
The sign of toxicity(ataxia and dysarthria) was in the range of therapeutic blood level and 3 of those subject with the sign of toxicity had history of brain damage and abnormal findings of computerized axial tomography of brain.
So, the anticonvulsant medication may have an adverse effect on the mental processes of epileptic patients quite apart from an inderectly beneficial effects from controlling seizures in the range of therapeutic blood level.
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