Trick or treat? cognitive side-effects of antiepileptic treatment

Treating epilepsy is about striking the right balance between the effectiveness of the treatment (controlling the epileptic episodes) and tolerating the medication (the side effects). There are different antiepileptic drugs and non-pharmacological treatment options available for which the cognitive effects are known. Fluid cognitive functions and mental speed in particular are often the first to be affected. Subjective patient experiences are useful in identifying these cognitive effects in a clinical setting. We used a brain scan to determine why these side effects occur. Using MR spectroscopy, we were able to associate mental slowness with a reduction in stimulating neurotransmitter (glutamate) function and an fMRI helped us to identify changes in brain connectivity.