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Published on: September 20, 2024
The Study of Carotid Artery Intima-Media Thickness in Children With Epilepsy on Anti-Epileptic Drugs
Khaled Amin Nasef1, Moustafa Kotb Elmala2, Alsayed Mohamed Sayed Ahmed3
1Cairo University, Cairo, Egypt.
Insights
Long-term use of antiepileptic drugs (AEDs) like valproate, carbamazepine, and levetiracetam in children with epilepsy is linked to increased carotid artery intima-media thickness (CIMT). This suggests potential cardiovascular risks associated with these common epilepsy treatments.
Area of Science:
- Pediatric Neurology
- Cardiovascular Health
- Pharmacology
Background:
- Epilepsy is a common neurological disorder in children.
- Long-term antiepileptic drug (AED) monotherapy is a standard treatment approach.
- Potential cardiovascular side effects of AEDs require thorough investigation.
Purpose of the Study:
- To assess carotid artery intima-media thickness (CIMT) in children with epilepsy on long-term AED monotherapy.
- To evaluate the lipid profile in these pediatric patients.
- To determine the association between specific AEDs and vascular changes.
Main Methods:
- A study involving 60 children with epilepsy on valproate, carbamazepine, or levetiracetam monotherapy.
- Comparison with 60 age-matched healthy controls.
- High-resolution B-mode ultrasound for CIMT measurement and serum lipid profile analysis.
Main Results:
- Children on valproate, carbamazepine, and levetiracetam showed significantly higher CIMT compared to controls.
- CIMT correlated positively with age, AED type (valproate, carbamazepine, levetiracetam), treatment duration, and lipid parameters (TC, TG, LDL).
- HDL showed a negative correlation with CIMT, while seizure severity and Apo A1 were not significant factors.
Conclusions:
- Long-term monotherapy with valproate, carbamazepine, and levetiracetam in children with epilepsy is associated with significant abnormalities in CIMT.
- These findings highlight potential subclinical vascular changes in pediatric epilepsy patients undergoing treatment.
- Further research is warranted to explore the long-term cardiovascular implications and potential preventive strategies.
Abstract:
Objectives. To evaluate carotid artery intima-media thickness (CIMT) and lipid profile in children with epilepsy on long-term antiepileptic drug (AED) monotherapy. Methods. We included 60 children with epilepsy receiving valproate, carbamazepine, or levetiracetam monotherapy and 60 controls. A high-resolution B-mode ultrasound was used to measure (CIMT). Measurement of serum lipids was done. Results. Patients on valproate (0.44 ± 0.03, P ≤ .001), carbamazepine (0.43 ± 0.03with P ≤ .001), and levetiracetam (0.44 ± 0.02 with P ≤ .001) monotherapy showed significantly higher CIMT compared to controls. CIMT was correlated with age (P = .041, r = .112) AEDs{valproate (P = .005, r = .731), carbamazepine (P = .038, r = .365), and levetiracetam (P = .036, r = .155)}, duration of treatment (P = .001, r = .313), TC(P = .001, r = .192), TG (P = .014, r = .018), and LDL (P = .001, r = .219). HDL (P = .003, r = -.126). Seizure severity and Apo A1 were insignificantly involved. Conclusion. Long-term monotherapy with valproate, carbamazepine, and levetiracetam in epileptic children was associated with significant abnormalities in CIMT.
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