Mechanisms of action of antiepileptic drugs and fine motor dexterity in generalized and localization -related /focal epilepsies.
Item
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Title
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Mechanisms of action of antiepileptic drugs and fine motor dexterity in generalized and localization -related /focal epilepsies.
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Identifier
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AAI3213180
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identifier
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3213180
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Creator
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Cheung, Angeles May.
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Contributor
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Adviser: Susan Croll
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Date
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2006
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Language
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English
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Publisher
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City University of New York.
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Subject
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Psychology, Physiological
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Abstract
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Antiepileptic drugs (AEDs) have been increasingly prescribed to manage seizures in patients with epilepsy and other neurologic and/or psychiatric disorders, which prompted many scientific inquiries of their associated cognitive effects. While research indicated AEDs' efficacy in up to 70% of the patients, they also implicated their role in worsening memory, attention, and other abilities such as fine motor dexterity. Questions remained as to what aspects of antiepileptic drug treatment influenced fine motor difficulty. This retrospective study attempted to examine the extent to which AEDs' mechanisms of action, duration of treatment, and the type of therapy (e.g., monotherapy vs. polytherapy) contributed to fine motor difficulty in adult patients with epilepsy. A review of medical records, as well as performance on measures of fine motor dexterity and speed, were performed in 164 patients with epilepsy. Results indicated the advantage of monotherapy with a sodium (Na+)-channel blocker over polytherapy with a Na+-channel blocker and a GABAergic enhancer. In addition, fine motor difficulty in patients treated with this combination regimen was associated with longer years of seizures and younger ages of seizure onset. Other variables such as gender, years of education, and FSIQ influenced a patient's susceptibility for fine motor difficulty, and indicated the relevance of cognitive reserve in that higher education and intellectual functioning was associated with better outcome. The findings suggested the importance of considering mechanisms of action and the type of therapy when devising an AED regimen for patients with epilepsy and other neurologic and/or psychiatric disorders. This would maximize efficacy and minimize behavioral effects such as fine motor difficulty, the presence of which interferes with a patient's quality of life and functional independence.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
