Metabolite alterations in autistic children: a 1H MR spectroscopy study.

PURPOSE: The purpose of this study was to assess the role of proton magnetic resonance spectroscopy (1H MRS) in the detection of changes in cerebral metabolite levels in autistic children. MATERIAL AND METHODS: Study group consisted of 12 children, aged 8-15 years, who were under the care of Pediatric Neurology Department and Pediatric Rehabilitation Department of Medical University of Bialystok. The diagnosis of autism was established by neurologist, psychiatrist and psychologist in every case. All patients matched the clinical criteria of the disease according to International Statistical Classification of Diseases and Related Health Problems (ICD-10). The control group included 16 healthy children aged 7-17. 1H MRS was performed with a single-voxel method (TE-36, TR-1500, NEX-192). The volume of interest (VOI) was located in the frontal lobe regions, separately on each side. RESULTS: We showed lower N-acetylaspartate/creatine (NAA/Cr), γ-aminobutyric acid /creatine (GABA/Cr) and glutamate/creatine (Glx/Cr) in the frontal lobes in the study group comparing with healthy controls. The ratio of myoinositol/creatine (mI/Cr) was increased in autistic children. No differences in choline/creatine (Cho/Cr) ratio in study group and controls were found. There was a correlation between age and NAA/Cr in autistic children (R=0.593 p=0.041). No significant differences in metabolite ratios between right and left hemisphere in ASD and controls were found. CONCLUSIONS: (1)H MRS can provide important information regarding abnormal brain metabolism. Differences in NAA/Cr, GABA/Cr, Glx/Cr and mI/Cr may contribute to the pathogenesis of autism.

Dysphagia in children with infantile cerebral palsy.

PURPOSE: Dysphagia is a significant health problem in children with infantile cerebral palsy (ICP), but not frequently discussed in the literature. The study objective was to analyse dysphagia symptoms in children with a pyramidal form of ICP, including the oral and pharyngeal phases of deglutition and dysarthria severity. We searched for a correlation between dysphagia severity and ICP type, mental development and occurrence of epilepsy. MATERIAL AND METHODS: A total of 67 children with a pyramidal form of infantile cerebral palsy were studied. Data were obtained based on case history elicited from the mothers, analysis of medical and psychological documentation, and logopaedic examination, including an examination of the action of swallowing. RESULTS: Dysphagia symptoms were found in 41 (61%) studied children, most frequently referring only to the oral phase (25 children), with concomitant mild and moderate dysarthria. Oral and pharyngeal dysfunctions were observed in 14 children and coexisted with more pronounced dysarthria symptoms. The most severe disorders were mainly found in the pharyngeal phase in 2 children. A statistically significant correlation was noted between the severity of dysphagia symptoms and the ICP type (p<0.044) and mental development (p<0.00002). CONCLUSIONS: Swallowing dysfunctions occur in the majority of children (>50%) with ICP. More serious disorders involving the oral and pharyngeal phases mainly affect children with tetraplegia and profound mental impairment. These disorders continue from early infancy through childhood and adolescence and improvement has been mainly observed when only the oral phase of swallowing is affected. These are always accompanied by dysarthria symptoms, which are especially severe when dysphagia involves the oral and pharyngeal phases. Early assessment and stimulation of the swallowing function should be a common element in the rehabilitation and care of children with ICP.

Somatosensory evoked potentials in epileptic children treated with carbamazepine or valproate in monotherapy - a preliminary study.

PURPOSE: Data from the literature suggest that long-term therapy with various antiepileptic drugs can be responsible for the functional disturbances within the nervous system e.g. peripheral neuropathy and encephalopathy. Useful and non-invasive instruments for evaluation of even subclinical nerve conduction abnormalities in somatosensory tracts are somatosensory evoked potentials (SEPs). The aim of this study was to assess the potentially drug-induced abnormalities in the SEP parameters in epileptic children, treated chronically in monotherapy with one of the two most often used antiepileptic drugs: valproate (VPA) or carbamazepine (CBZ). MATERIALS AND METHODS: SEP from left median nerve stimulation were recorded in twenty children with idiopathic/cryptogenic epilepsy treated in monotherapy with CBZ (9 patients) or VPA (11 patients). The mean age of the patients was 13.4 ± 2.9 years (range 7-17 years). The plasma concentrations of the drugs were consistently within therapeutic range. The mean duration of treatment was eight months. The control group consisted of twenty-four age-matched children with tension type headache. The latencies of the components: N9, N13, N20, P25 and the peripheral conduction time (PCT) and central conduction time (CCT) were analyzed. RESULTS: No significant differences in all analyzed SEP parameters between the epileptic and control children were found. CONCLUSIONS: Our results indicate that during the first 8 months from the beginning of antiepileptic treatment in children, monotherapy with VPA or CBZ does not induce nerve conduction disturbances within both the peripheral- and the central part of the somatosensory tracts, detected in SEP examination.

Annual variations of quantitative EEG in patients with chronic epilepsy.

PURPOSE: Annual changes in powers of the close-eyed EEG were measured over 12 months in 12 patients with epilepsy. MATERIAL AND METHODS: The present study included 12 patients aged 14.6+/-2.7 years with chronic epilepsy, suffering for 6-14 years. EEGs were recorded every month between 9 and 11 a.m. Five patients had generalized seizures and 7 partial complex seizures secondarily generalized. Visual analysis of EEG was performed before the quantitative assessment. The signals were recorded using a set of 14 (F3, F4, F7, F8, C3, C4, P3, P4, 01, 02, T3, T4, T5, T6) scalp electrodes. For each patient, 20 artifact-free EEG epochs, each of 2 s. duration were selected for spectral analysis to calculate spectral power. The sampling frequency was 240 Hz. Frequencies below 1 Hz and above 70 Hz were eliminated by digital filtering. The channels were recorded relative to a vertex reference. A fast Fourier transformation algorithm of signal processing was used to obtain the power spectrum of each lead. Absolute power spectrum was calculated within 4 frequency bands: delta (1-3.99 Hz), theta (4-7.99 Hz), alpha (8-12.99 Hz), and beta (13-30.99 Hz). RESULTS: We found the abnormalities to be predominantly focal in EEG. None of the EEG recordings were normal, and the power spectra differed over the year. A statistically significant increase of delta and theta bands in May and a decrease of alpha bands in September was found. We did not find positive correlations between the changes in the quantitative EEG analysis and the number of seizures in patients. CONCLUSIONS: These findings suggest the annual variations of EEG in patients with chronic epilepsy. Furthermore studies are needed to clarify the annual variations of EEG among healthy volunteers.

Clinical and neuroimaging profile of congenital brain malformations in children with spastic cerebral palsy.

PURPOSE: Analysis of the incidence of congenital brain malformations in children with spastic cerebral palsy (CP) in a hospital-based study. MATERIAL AND METHODS: The present study included 74 boys and 56 girls with spastic tetraplegia, diplegia, and hemiplegia CP. Magnetic resonance imaging MRI findings were analyzed in children with CP. RESULTS: Significant abnormalities relevant to the CP were evident on MRI in 124 (95.3%) subjects. Periventicular leukomalacia (PVL) was detected more frequently in children with spastic diplegia than in patients with tetraplegia or hemiplegia. Cerebral atrophy was found more often in the tetraplegic group compared to the diplegic patients. Porencephalic cysts were detected more often in children with spastic hemiplegia. Congenital brain anomalies were evident in 15 (10.7%) children with spastic CP. Brain malformations included: schizencephaly (5), agenesis corpus callosum (4), polymicrogyria (2), holoprosencephaly (2) and lissencephaly (2). Intractable epilepsy and mental retardation were observed more often in children with brain anomalies. Twelve patients with congenital brain malformations were born at term and three born at preterm. CONCLUSIONS: Neuroimaging results in children with CP may help determine the etiology and make better prognosis of CP.

Topiramate as a neuroprotectant in the experimental model of febrile seizures.

PURPOSE: The aim of the study wad to estimate a potentially neuroprotective effect of topiramate (TPM) in the experimental model of FS. MATERIAL AND METHODS: 24 young male rats divided in 4 groups were involved in the study. Febrile seizures were induced by placing the animals in 45 degrees C warm water bath for four consecutive days. TPM at the dose 80 mg/kg b.m. was administered: before the FS and immediately after the FS. FS group and control rats received only normal saline. Thereafter hippocampal slices were prepared to performing histological and morphometric examination. RESULTS: Morphometric investigations revealed that FS caused death of 60% of the neurons in sector CA1 and a half of them in sector CA3. Histological examinations of hippocampal slices showed that TPM at a dose of 80 mg/kg b.m., administered before the seizures, considerably improved CA1 and CA3 pyramidal cell survival. Similar neuroprotective effect, but in a markedly lesser degree was observed when TPM was administrated after the FS. CONCLUSIONS: Our findings seem to confirm that FS exert a strong destructive effect on the sensitive hippocampal neurons and on the neuroprotective properties of TPM in this process, which may have practical implications. It can be assumed that in children with recurrent and prolonged FS, prophylactic drug administration could prevent hippocampal sclerosis and development of symptomatic epilepsy.

Cortical somatosensory evoked potentials and spasticity assessment after botulinum toxin type A injection in children with cerebral palsy.

PURPOSE: The mechanism of Botulinum Toxin Type A (BTX-A) action at the neuromuscular junction is well known. But from the introduction of BTX-A, some authors have suggested a central action of BTX-A and possible side effects far from the site of injection. Some studies demonstrate an improvement of cortical SEPs associated with reduction of spasticity after BTX-A injection. The aim of the present study was to determine the effect of BTX-A treatment on cortical somatosensory potentials (SEP). MATERIAL AND METHODS: A group of twenty nine children ranging from 2 to 17 years old with cerebral palsy were studied. Each patients spasticity level was evaluated before, 2 weeks and 6 weeks after BTX-A injection by the Modified Ashworth Scale and modified Gait Physician's Rating Scale. The SEPs from lower and upper extremities were performed before and between 2 and 6 weeks (19.34 +/- 8.82 days) after BTX-A administration. RESULTS: The mean spasitity level was significantly lower 2 and 6 weeks after BTX-A injection. The gait analysis by modified Physician's Rating Scale (PRS) showed significant improvement two weeks and six weeks after BTX-A injection. SEPs results were abnormal before BTX-A injection in 25 children with cerebral palsy. However we didn't find any significant changes of SEPs latencies after BTX-A injection. CONCLUSIONS: The results of SEP after BTX-A administration in children with cerebral palsy do not confirm the central action of BTX-A on somatosensory pathways. We did not find any significant changes of SEP latencies associated with clinical reduction of spasticity. It seems that SEP results could support the opinion, that BTX-A does not have any direct central effect on sensory pathways. Remote side effects may be explained by an indirect mechanism due to modification of the central loops of reflexes or to hematogenous spread of BTX-A.

Magnetic resonance imaging of the cerebellum and brain stem in children with cerebral palsy.

PURPOSE: The study aimed to examine the volumes of cerebellum and the brain stem in children with cerebral palsy (CP). MATERIAL AND METHODS: The present study included 21 children with spastic diplegic CP (11 girls and 10 boys). Twenty-one patients with CP were age- and gender-matched with the control patients. All subjects were free from neurological or psychiatric disease, had normal intellectual development, and their brain magnetic resonance imaging (MRI) scans were normal. MRI of forty-two patients were reviewed prospectively. RESULTS: The CP group had significantly smaller mean of the cerebellar hemispheres and the brain stem than did the control group. The cerebellar volumes were positively correlated with age of children with CP and the control group. No significant correlations between gender and the volumes of cerebellar hemispheres and the brain stem in controls and in the CP group were found. No significant correlations between asphyxia and the volumes of cerebellar hemispheres and the brain stem in the CP group were noted. Positive correlation between the cerebellum volume and IQ scores in children with CP was found. Negative relationship between the cerebellar hemispheres volume and Gross Motor Function Classification System in patients with CP was found. No significant correlation between the brain stem volume and IQ scores in the CP group was detected. CONCLUSION: Our data demonstrate that children with CP had smaller volumes of the cerebellum and the brain stem as compared to controls.

Brain metabolic profile obtained by proton magnetic resonance spectroscopy HMRS in children with Down syndrome.

PURPOSE: Down syndrome (DS), or trisomia 21, is one of the most common autosomal mutations, with mental impairment as the constant symptom. Proton magnetic resonance spectroscopy (1HMRS) allows evaluation of this metabolism in DS children. The study objective was the morphological evaluation of the brain in magnetic resonance imaging (MRI) and assessment of the metabolic profile obtained by HMRS in children with DS. MATERIAL AND METHODS: The study involved 34 children, including 14 with DS, aged 7-17 years. All of them were patients of the Department of Pediatric Neurology and Rehabilitation, Medical University of Bialystok, and of its Outpatient Clinic. Age-matched healthy children (n = 20) served as control. MRI scans of the head were performed in DS children using a 1.5T MR scanner in standard conditions, in three planes (saggital, axial and coronal), in T1, T2, PD and FLAIR series. HMRS investigations were also conducted to assess metabolic changes in the frontal lobes. Such metabolites as Glx, NAA, Cho, ml and GABA were determined in both temporal lobes with reference to the internal marker Cr. Results were compared to the control group. RESULTS: The MRI revealed no structural changes in children with DS. We found a decrease in Glx/Cr, NAA/Cr, Cho/Cr and ml/Cr ratios in our DS patients as compared to the control group. The differences for the first two markers were statistically significant. However, no differences were found between GABA/Cr ratio in the two frontal lobes in patients with DS as compared to the control group. CONCLUSIONS: Our findings seem to confirm the abnormal metabolism of stimulatory amino acids with developmental disorders and "precocious brain aging" in children with DS.

Severity of dysarthric speech in children with infantile cerebral palsy in correlation with the brain CT and MRI.

PURPOSE: Dysarthria is a sequel of reduced motor functions and refers to the sound aspect of the language. In children suffering from cerebral palsy, CT (computer tomography) and MRI (magnetic resonance imaging) examinations provide data on the relationship between the range of structural changes detected by neuroimaging investigations and the severity of motor dysfunction. The aim of study was to assess the severity of dysarthria in children with cerebral palsy in correlation with the pattern of morphological changes revealed on CT and MRI. MATERIAL AND METHODS: The study involved 48 children with the pyramidal form of infantile cerebral palsy aged 3-15 years, treated in the Department of Pediatric Neurology and Rehabilitation in Bialystok. All the patients underwent CT examination, 29 of them also had MRI. Severity of speech dysfunction was established based on "Dysarthria profile" by Robertson. The degree of damage severity in the respective brain structures was determined according to the scale Kraegeloh-Mann. Statistical analysis was performed using % calculations, the arithmetic mean, standard deviation, the chi-square test of independence or t-Student test to compare the means of two samples. RESULTS: Significant differences were shown in dysarthria severity depending on lesions seen on CT and their intensity revealed by MRI, which were found to correlate positively with the severity of articulation disorders. CONCLUSIONS: The results indicate that CT and MRI are useful for predicting prognosis of severity of speech disturbances in children and for early programming of the therapeutic process.

Clinical-electroencephalographic analysis of brain bioelectrical activity in children with myelomeningocele and internal hydrocephalus.

PURPOSE: The aim of the current study was the clinical and electroencephalographic (EEG) analysis of the brain bioelectrical activity in patients with myelomeningocele and internal hydrocephalus. MATERIAL AND METHODS: The present study included 86 children (44 boys and 42 girls) with myelomeningocele. The children were aged 1-17 years (mean 7 +/- 4.4 years). Thoracic myelomeningocele was identified in 24 children (28%), lumbar in 53 (62%) and sacral in 9 cases (10%). RESULTS: The standard EEG examination performed in the waking state revealed generalized changes in 53 patients (62%), including 19 (79%) with thoracic, 28 (53%) with lumbar and 6 (66%) with sacral myelomeningocele. Approximately 70% of the patients underwent ventriculoperitoneal shunting and epilepsy was found in 27 children (31.4%). The prevalence of changes detected in the left temporal region did not differ between the respective myelomeningocele types. No correlations were noted between the degree of spinal cord injury and the changes observed in the left temporal region in EEG recording. Likewise, changes found in the centroparietal region in EEG did not correlate with the site of myelomeningocele. Focal changes in the frontotemporal (p < 0.0067) and right temporal region (p < 0.0314) showed a positive correlation with the degree of spinal cord injury and were most frequent in patients with thoracic myelomeningocele. CONCLUSION: The analysis of EEG might facilitate evaluation and prognosis of epileptic seizures in children with myelomeningocele and internal hydrocephalus.

Antioxidant activity of blood serum and saliva in patients with periodontal disease treated due to epilepsy.

PURPOSE: The aim of the study was to estimate the activity of chosen antioxidants in blood serum and saliva in patients with periodontal disease treated due to epilepsy. MATERIAL AND METHODS: Twenty-five epileptics and fifteen control persons were involved in the study. The activity of selected endogenous antioxidants were determined by spectrophotometric assay. Concentrations of vitamin A and vitamin E were measured using liquid chromatography. RESULTS: The analysis of the serum and saliva from patients with overgrown gingiva revealed: reduced activity of superoxide dismutase, glutathione peroxidase and glutathione reductase, elevated lipid peroxides, and decreased concentration of ascorbic acid and alpha-tocopherol. All values were statistically significant. CONCLUSIONS: Our results indicate on the oxidant-antioxidant disturbances in epileptic patients, which can play an important role in the pathomechanism of periodontal disease in these persons. Further studies on the role of antioxidants in patients with epilepsy treated with antiepileptic drugs and afflicted with gingival hyperplasia will be continued.

Low back pain in school-age children: risk factors, clinical features and diagnostic managment.

PURPOSE: Low back pain (LBP) is common in adult population, and it is becoming a serious health concern in adolescents. On surveys, about every fifth child in the school-age reports LBP. The study objective was to analysis the natural history, risk factors, clinical symptoms, causes and diagnostic management in school-age children hospitalized with LBP. MATERIAL AND METHODS: The study group consisted of 36 patients at the age between 10 and 18 years, 22 girls and 14 boys suffering from LBP hospitalized in our Department of Pediatric Neurology and Rehabilitation in years 2000-2004. RESULTS: The mean age of clinical onset of LBP in our group was 14.7 years, earlier in girls, later in boys. We find the family history of LBP in 50% children. Most frequent factors associated with LBP were: spina bifida (16.7%) and incorrect posture (13.9%). Half of patients pointed the factor initialising LBP: rapid, incoordinated move (39%) or heavy load rise (11%). 58% of patients present the symptoms of ischialgia. Diagnostic imaging showed disc protrusion in 11 children (31%) 6 in computed tomography, 4 in magnetic resonance imaging and 1 in X-Ray examination only. Other causes of LBP included: spondylolysis in 2 patients, Scheuermann disease in one case and juvenile reumatoid arthritis in one case. CONCLUSIONS: Some school-age children suffering on low back pain, particulary with sciatic neuralgia symptoms seek medical care in hospital. Althought the main causes are mechanical, associated with lack of physical activity or strenous exercise, serious diagnostic managment is strongly recommended.

Proton magnetic resonance spectroscopy in patients with normal pressure hydrocephalus.

The objective of this prospective study was the application of proton magnetic resonance spectroscopy (1HMRS) in patients with normal pressure hydrocephalus (NPH) to determine the metabolite profile in the white matter next to left lateral ventricle and to assess the relationship of this profile with Evan's index. The study included 26 patients with NPH. Diagnosis of NPH was confirmed by clinical symptoms such as gait disturbance, dementia or urinary incontinence and CT study with ventricular enlargement. Ratios of NAA/Cr, Cho/Cr, Lac/Cr and mI/Cr from deep white matter were measured and compared with Evan's index and diameter of the IIIrd ventricle. Patients with hydrocephalus showed decreased ratios of N-acetylaspartate (NAA)/Cr (creatine), and increased ratios of Lac(lactate)/Cr in the white matter near the left frontal horn of the lateral ventricle compared with a well-matched control group. There was no correlation between NAA/Cr, Ch/Cr, Lac/Cr, mI (myo-Inositol)/Cr and Evan's index. A significant correlation was found between Lac/Cr and third ventricle diameter. A positive correlation was noted between Cho/Cr and dementia in patients with NPH. Our preliminary results of 1 H MRS support the idea that NPH is associated with white matter ischemia. Proton MRS is a very useful tool for evaluating major changes in metabolic levels in deep white matter in NPH patients.

Quantitative EEG analysis of REM sleep in children with Down syndrome.

PURPOSE: The aim was to compare quantitative EEG analysis of REM sleep in children with Down syndrome (DS) and normal age-matched controls. MATERIAL AND METHODS: Twenty-one channel EEG of 21 patients with Down syndrome and 21 normal children, with ages ranging from 1 to 8 years, were submitted to quantitative analysis EEG of discharge-free epochs. The signals were recorded using a set of 17 (F3, F4, F7, F8, Fz, C3, C4, Cz, P3, P4, Pz, O1, O2, T3, T4, T5, T6) scalp electrodes. For each child, 20 artifact-free EEG epochs, each of 2 s without epileptiform discharges were selected for spectral analysis to calculate spectral power. Delta, theta, alpha and beta frequency ranges were compared between groups for all electrode positions. RESULTS: Quantitative analysis of the REM sleep from DS group disclosed reduction of the power mainly in the alpha when comparing the healthy group. Beta, theta and delta bands did not differ significantly between the groups. CONCLUSIONS: Our findings agree with recent evidences that these children may differ from children normal development.

Neurophysiologic studies of brain plasticity in children with cerebral palsy.

The mechanisms of brain plasticity include: a change in the balance of excitation and inhibition; a long-term potentiation or long-term depression; a change in neuronal membrane excitability; the anatomical changes-formation of new axon terminals and new synapses. There are few tools for brain plasticity investigations. The utility of the neurophysiologic in the determination of brain reorganization and repair in patients with cerebral palsy (CP) are described. The authors discuss also their results of quantitative EEG, visual evoked potentials (VEPs) and somatosensory evoked potentials (SEPs) in children with CP. They showed the existence of brain reorganization and repair in children with CP.

Time of cooing appearance and further development of speech in children with cerebral palsy.

PURPOSE: The aim of the study was to determine the significance of the time of cooing appearance for further development of speech in children with infantile cerebral palsy (CP). MATERIAL AND METHODS: The study was performed on a group of 46 children with the pyramidal form of CP, aged 3-16 years, treated in The Department of Pediatric Neurology and Rehabilitation, Medical University of Bialystok. It included a logopaedic assessment and a history of speech development obtained from mothers. RESULTS: Speech development in CP children varied according to the time of cooing appearance. Particular difficulties were observed in children with delayed cooing, who usually said their first words between 2 and 5 years of age, sentences between 3 and 5 years or even later (8 or 11 years of age); 35% of these children did not use sentences at all. Moderate and severe dysarthria, limited lexical and grammatical development and problems with speech understanding of varied degree were observed. CONCLUSIONS: Delayed cooing in CP is an important prognostic sign of further speech retardation and indicates the necessity of early logopaedic rehabilitation.

The cortical evoked potentials in children with developmental coordination disorder (DCD).

PURPOSE: Evoked potentials were recorded in patients with DCD to evaluate the integrity the afferent pathways and to rule out the presence of any neurological lesions. MATERIAL AND METHODS: Two boys: 5 and 16 years old with recognized DCD were examined. Battery of tests: short-latency somatosensory evoked potentials (SEP), pattern-reversal visual evoked potentials (VEP), cognitive event-related potentials (CERP) and EEG were recorded. CT and neuropsychological assessment were also performed. RESULTS: N20 and P25 latencies and also central conduction time of SEPs in both patients were longer. N9, N11, N13 latencies were normal. VEP, CERP, EEG and neuroimaging scans were normal. CONCLUSIONS: Relationship among perceptual--motor skills, cognitive impairment and electrophysiologic findings in children with developmental dyspraxia are discussed. The disturbances of the integrity of the afferent pathways could to be one of many causal factors. Further researches are required to determine the specific source of the neurological deficit of clumsy children.

Neuroprotection possibilities in epileptic children.

PURPOSE: The aim of this paper was to summarize of current knowledge about neuronal injuries during epileptogenesis process and possibilities of neuroprotection. RESULTS: Many of agents from a wide range of classes have been proposed to possess neuroprotective potential, but especially in experimental and preclinical conditions. Among the antiepileptic drugs topiramate (TPM) and levetiracetam (LEV) possess neuroprotective effects in experimental models of brain damage. Promising protection against cell loss display antioxidants and neurotrophins. CONCLUSIONS: Important and difficult problem of neuroprotective therapy in childhood epilepsy require further experimental and clinical investigations.

New antiepileptic drugs--an overview.

The last ten years of the 20th century is called in neuroscience "decade of the brain". This period has brought many new antiepileptic drugs (AEDs) to the practising physician. New AEDs include: vigabatrin, lamotrigine, topiramate, tiagabine, gabapentin, oxcarbazepine, levetiracetam and zonisamide (not registered in Poland). The development of these drugs was under the current epilepsy theory (balance-disturbances between inhibitory and excitatory neurotransmitters in the brain). Mechanism of action of the new AEDs is due to increase of the GABA-system activity and/or reaction with ion-channels events in neurons. The aim of the study was an overview of the current literature on the new AEDs in the treatment of seizures and epileptic syndromes. Data from literature show that the new AEDs are better tolerated, have fewer drug interactions and seem to affect cognitive functions to a lesser degree compared to the conventional drugs. Most of them are recommended to an add-on therapy of partial seizures with/without second generalization, although there are more evidences on efficacy of new AEDs in monotherapy. The new AEDs seemed to be similar to the conventional drugs in efficacy, but superior in tolerability. New AEDs with more selective activity and lower toxicity have been significant improved the quality of life in the epileptic patients. Numerous chemical compounds with potential antiepileptic activity are in experimental and clinical development.