Effects of Lamotrigine on Problem-Solving Abilities in Newly Diagnosed Pediatric Patients with Epilepsy

Background and purpose: This study aimed to determine the effects of lamotrigine (LTG) on language unction, including problem-solving abilities, in newly diagnosed pediatric epileptic patients.

Methods: This study included 112 newly diagnosed epileptic patients treated with LTG [69 males and 43 females aged 9.6±2.7 years (mean±SD)]. Repeated neurologic examinations, electroencephalography, neuroimaging studies, and standard language tests including the Test of Problem Solving (TOPS), mean length of utterance in words (MLU-w), Receptive and Expressive Vocabulary Test (REVT), and Urimal Test of Articulation and Phonology were performed before and after initiating LTG treatment. The starting LTG dosage was 1 mg/kg/day (maximum: 25 mg/day) for the first 14 days, which was increased to 2 mg/kg/day for the subsequent 14 days and then up to 7 mg/kg/day (or 200 mg/day) for maintenance.

Results: Problem-solving skills as assessed by TOPS scores significantly improved after initiating LTG treatment (33.5±14.5 vs. 35.7±14.25, p<0.01). Scores in the "determining causes" category (11.9±4.7 vs. 12.9±4.8, p<0.01), "making inferences" category (12.9±6.2 vs. 13.6±6.0, p<0.05), and "predicting" category (8.9±5.4 vs. 9.7±5.6, p<0.01) significantly improved after LTG treatment. The MLU-w score did not decrease after LTG treatment (4.7±1.9 vs. 5.0±2.1). There was a significant improvement in receptive language function as assessed using the REVT score (9.4±3.4 years vs. 9.9±3.3 years, p<0.01). Precise articulation also improved after initiating LTG treatment (97.8% vs. 98.5%).

Conclusions: Language function including problem-solving skills improved after LTG treatment, suggesting that LTG can be administered without causing significant negative effects on language function in pediatric patients.