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Effects of antiepileptic drugs on evoked potentials in epileptic children
A Verrotti1, D Trotta, R Cutarella
1Department of Pediatrics, University of Chieti, Chiety, Italy.
Insights
Carbamazepine and sodium valproate monotherapy in children with epilepsy can cause visual and auditory pathway dysfunction after 12 months. Phenobarbital showed no significant effects on these sensory pathways.
Area of Science:
- Neuroscience
- Clinical Neurology
- Pediatric Epilepsy
Background:
- Epilepsy is a common neurological disorder in children.
- Antiepileptic drugs (AEDs) are the primary treatment for epilepsy.
- Long-term effects of AEDs on sensory functions require thorough investigation.
Purpose of the Study:
- To assess visual and auditory pathway function in pediatric epilepsy patients on monotherapy.
- To compare the effects of sodium valproate, carbamazepine, and phenobarbital on sensory evoked potentials.
- To identify potential electrophysiological changes associated with specific AEDs.
Main Methods:
- Evaluated 58 epileptic children and adolescents (ages 13.7 ± 6.9) on monotherapy.
- Measured visual-evoked potentials (VEPs) and brainstem auditory-evoked potentials (BAEPs).
- Compared measurements before therapy and after 12 months against 50 healthy controls.
Main Results:
- Carbamazepine treatment significantly increased P100 latencies (VEP) and peak latencies/interpeak intervals (BAEP) after 12 months.
- Sodium valproate treatment significantly increased VEP P100 latencies.
- Phenobarbital monotherapy did not result in significant visual or auditory pathway abnormalities.
Conclusions:
- Carbamazepine and sodium valproate monotherapy in pediatric epilepsy patients can lead to electrophysiological dysfunction in visual and auditory pathways.
- Phenobarbital appears to be a safer option regarding sensory pathway integrity in this context.
- Long-term monitoring of sensory function is recommended for children on carbamazepine and sodium valproate.
Abstract:
To evaluate the visual and auditory function in children and adolescents who are undergoing monotherapy with sodium valproate, carbamazepine, and phenobarbital visual-evoked potentials and brainstem auditory-evoked potentials were measured in 58 epileptic patients (30 males and 28 females), ages 13.7 +/- 6.9 years. Fifty healthy sex- and age-matched children served as controls. The measurements were performed before the beginning of therapy and after 12 months. Before the beginning of therapy, there were no significant differences in visual- and auditory-evoked potentials between the control group and the three groups of epileptic children. After 12 months of therapy, patients treated with carbamazepine demonstrated a significant (P < 0.001) increase of P100 latencies when compared with baseline data and control values; moreover, these patients exhibited a significant increase of peak latencies of waves I-III-V and interpeak interval I-V at auditory second evaluation. The patients treated with sodium valproate manifested a significant (P < 0.05) increase in VEP P100 latencies. On the contrary, children receiving phenobarbital did not manifest any significant abnormality at visual- and auditory-evoked potentials measurements. Our study demonstrates that for patients treated with carbamazepine and sodium valproate, an electrophysiologic dysfunction of visual and auditory sensory pathways can be present after 12 months of treatment.
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