Effects of Topiramate on Language Functions in Newly Diagnosed Pediatric Epileptic Patients

BACKGROUND: The aim of this study was to characterize the effects of topiramate on language functions in newly diagnosed pediatric epileptic patients. METHODS: Thirty-eight newly diagnosed epileptic patients were assessed using standard language tests. Data were collected before and after beginning topiramate during which time a monotherapy treatment regimen was maintained. Language tests included the Test of Language Problem Solving Abilities, a Korean version of the Peabody Picture Vocabulary Test. We used language tests in the Korean version because all the patients were spoken Korean exclusively in their families. RESULTS: All the language parameters of Test of Language Problem Solving Abilities worsened after initiation of topiramate (determine cause, 13.2 +/- 4.8 to 11.2 +/- 4.3; problem solving, 14.8 +/- 6.0 to 12.8 +/- 5.0; predicting, 9.8 +/- 3.6 to 8.8 +/- 4.6). Patients given topiramate exhibited a shortened mean length of utterance in words during response (determine cause, 4.8 +/- 0.9 to 4.3 +/- 0.7; making inference, 4.5 +/- 0.8 to 4.1 +/- 1.1; predicting, 5.2 +/- 1.0 to 4.7 +/- 0.6; P < 0.05), provided ambiguous answers during the testing, exhibited difficulty in selecting appropriate words, took more time to provide answers, and used incorrect grammar. However, there were no statistically significant changes in the receptive language of patients after taking topiramate (95.4 +/- 20.4 to 100.8 +/- 19.1). CONCLUSIONS: Our data suggest that topiramate may have negative effects on problem-solving abilities in children. We recommend performing language tests should be considered in children being treated with topiramate.