近二十年来逐渐认识到许多抗痫药(AEDs)先前未察觉的隐袭的毒性作用。同时,血药浓度监测技术的发展促进了单药治疗癫痫;减少不必要的多药治疗增进了了解AEDs对认识功能和行为的微妙影响。本文重点讨论长期AEDs治疗的神经精神副作用,尤其是对认识功能和行为的研究。一、神经系统副作用 1.周围神经病约1/3 AEDs治疗病人出现下肢反射消失及踝部振动觉障碍。罕见肢端感觉异常或无力。电生理异常较临床表现多见。一致认为苯妥英(DPH)是周围神经病的祸首,但Shorvon和Reynolds发现长期巴比妥治疗也可导致周围神经功能临床或电生理的异常。酰胺咪嗪(CBZ)和丙戊酸钠 For almost two decades, it has come to realize the previously unidentified insidious toxic effects of many antiepileptic drugs (AEDs). At the same time, the development of plasma concentration monitoring technology has facilitated the monotherapy of epilepsy; reducing unnecessary multidrug therapy has increased the understanding of the subtle effects AEDs has on cognitive function and behavior. This article focuses on the neuropsychiatric side effects of long-term AEDs treatment, especially on cognitive function and behavior. First, the nervous system side effects 1. Peripheral neuropathy about 1/3 AEDs treatment of patients with lower limb reflex disappeared and ankle vibration dyskinesia. Rare acral abnormalities or weakness. Electrophysiological abnormalities more common than clinical manifestations. Phenytoin (DPH) was consistently identified as the culprit in peripheral neuropathy, but Shorvon and Reynolds found that long-term barbituation also resulted in clinical or electrophysiological abnormalities in peripheral nerve function. Amikacin (CBZ) and sodium valproate