METHODS: CAED aged 8-12 years were recruited from the Kerala Registry of epilepsy and pregnancy that prospectively follows up children of women with epilepsy and COAED from children attending the imaging department for minor illnesses. Maternal clinical details and the neuropsychological data including IQ of CAED and COAED were obtained. Total intracranial volume (TBV), grey matter volume (GMV), white matter volume (WMV) and volumes of deep grey matter were measured by Voxel Based Morphometry.
RESULTS: We studied 30 CAED (mean age 10.8+1.11 years) and 35 COAED (mean age 10.64+1.26). The antenatal AED exposure for the CAED was monotherapy for 8 children and polytherapy for 22 children. The CAED had significantly lower (P<0.001) IQ (77.5+13.8), TBV(1259.55±169.85mL) and GMV (672.51±85.42 mL) compared to the IQ (87.0+13.5), TBV(1405.37±161mL) and GMV (745.427±86.69 mL) of COAED. CAED had lower volumes for Lt Inferior Triangular Gyrus, and hippocampi on both sides, when compared to COAED. Group analysis CAED showed less GMV (P<0.05) for left inferior and middle frontal gyri relative to COAED.
CONCLUSIONS: These observations point towards an anatomical basis of lower GMV for the lower neuropsychological functions in children with antenatal AED exposure.