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Vestibular function in children with generalized epilepsy and treated with valproate
Sherifa Ahmed Hamed1, Amira Mohamed Osiely2
1Department of Neurology and Psychiatry, Assiut University Hospital, Assiut, Egypt.
Insights
Vestibular dysfunction is common in children with epilepsy, affecting over 65%. This may be linked to epilepsy duration and valproate treatment, impacting their quality of life.
Area of Science:
- Neurology
- Pediatrics
- Otolaryngology
Background:
- Vestibular function studies in children with epilepsy are less common than auditory studies.
- This research focuses on assessing vestibular function in children during their inter-ictal period.
Purpose of the Study:
- To evaluate vestibular function in children diagnosed with generalized epilepsy.
- To identify potential correlations between vestibular dysfunction, epilepsy characteristics, and valproate treatment.
Main Methods:
- A cross-sectional study involving 35 children with epilepsy and 24 healthy controls.
- Vestibular function assessed using videonystagmography (VNG) and cervical vestibular evoked myogenic potentials (cVEMPs).
Main Results:
- 65.71% of children with epilepsy exhibited vestibular dysfunctions (VDs), primarily peripheral.
- Peripheral VDs included unilateral caloric weakness and reduced cVEMP amplitudes; central VDs involved oculomotor abnormalities and positional nystagmus.
- VDs correlated significantly with epilepsy duration, treatment duration, and valproate dosage and levels.
Conclusions:
- Vestibular dysfunction is prevalent in children with epilepsy, with peripheral dysfunction being more common.
- Valproate treatment may contribute to peripheral vestibular dysfunction.
- Epilepsy itself may also play a role in central vestibular dysfunction.
Background:
Studies that evaluated vestibular function with epilepsy are fewer than auditory studies. We assessed vestibular function in children with epilepsy in inter-ictal period.
Research Design And Methods:
This cross-sectional study included 35 children with generalized epilepsy (boys=15; girls=20; age=11.20±1.21 years; epilepsy duration=3.54±1.80 years) and treated with valproate (VPA) and 24 healthy children. Vestibular evaluation was conducted using videonystagmography (VNG) and cervical vestibular evoked myogenic potentials (cVEMPs).
Results:
Dizziness was the vestibular symptom in 22.86% of cases. Vestibular dysfunctions (VDs) were found in 65.71%. Manifestations of peripheral VD (65.71%) included unilateral caloric weakness and reduced cVEMP amplitudes. Manifestations of central VD (28.57%) included oculomotor abnormalities, positional nystagmus with normal calorics, and prolonged cVEMPs latencies. Significant correlations were found between VDs and duration of epilepsy and its treatment [r = -0.368, P=0.01] and VPA dose [r = -0.286, P=0.02] and level [r = -0.355, P=0.01]. Logistic regression analysis showed that duration of epilepsy and its treatment [OR = 3.55 (95% CI = 2.54-6.50), P=0.001] were independently associated with VDs.
Conclusions:
VDs are common in children with epilepsy. Bilateral peripheral VD was more common than central VD, suggesting an adverse effect of VPA. However, epilepsy cannot be excluded as a cause of central VD.
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