Effects of Piracetam on Cognitive Functions and Serum Antiepileptic Drugs Concentration in Epileptic Children

Objective:To investigate the effects of piracetam on antiepileptic drugs(AED)valproate(VPA) and carbamazepine(CBZ) serum concentration,and the cognitive function in children with epilepsy.Methods: Altogether 52 epileptic children completed this self-control study,and among them 24 cases of generalized seizures received VPA treatment(VPA group) and 28 cases of partial seizures received CBZ treatment(CBZ group).The serum levels of CBZ and VPA were tested by fluorescence polarization immunoassay (FPIA) and the cognitive function was tested with the Raven's standard progressive matrices(SPM) and P300 in event-related potentials before AEDs therapy,3 months after AEDs therapy,9 months after adding piracetam.The control of 23 health children from primary and secondary schools were tested once.Results: Intelligence quotient(IQ) of the control were significantly higher than those in VPA and CBZ groups [(98.3±10.8) vs (74.5±11.3) and(81.5±12.0),P0.01].Before AEDs therapy,P300 latency of VPA and CBZ groups were longer than the control [(379.6±39.1) ms and(371.3±31.2) ms vs.(313.5±27.6) ms,P0.01],and amplitude(P300Amp) were lower [(5.1±1.2) μv and(5.8±1.4) μv vs.(8.2±1.8) μv,P0.01].After 3 months' AEDs treatment,P300 latency of VPA and CBZ groups were gradually reduced and P300Amp increased.among which the difference in P300 latency of VPA group had statistical significance [(379.6±39.1) ms vs.(357.4±27.3) ms,P0.01].AEDs treatment for 9 months after adding piracetam,P300 latency of VPA and CBZ groups were obviously reduced [(333.8±29.5) ms vs.(341.7±28.3) ms,P0.01)] and P300Amp increased [(6.7±1.5) μv vs.(6.4±1.7) μv,P0.01].The differences in IQ and serum levels of CBZ and VPA were not significant(P0.05) before and after adding piracetam.Conclusion: Piracetam can not attenuate the metabolism and serum concentration of AEDs,CBZ and VPA,but can reduce cognitive impairment by improving the response ability in epileptic children.