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Introduction: Many studies have suggested that the plasma homocysteine level is increased as a side effect with prolonged use of some antiepileptic drugs, which is associated with increase Carotid intima media thickness; hence it increases the risk of atherosclerosis in young age. Objectives: To assess serum level of homocysteine in epileptic children on long standing antiepileptic drugs and its association with increased incidence of cardiovascular disease. Patients and methods: This study will include 85 children between 2-15 years (20 on one old generation antiepileptic drug, 20 on one new generation antiepileptic drug, 20 on polytherapy of antiepileptic drugs on antiepileptic drugs for at least 1 year and 25 apparently healthy children will be taken as a control group). All of them subject to careful history taken, clinical examination and anthropometric measures, laboratory investigation included (serum homocysteine) and radiological assessment included (carotid intima media thickness and carotid stiffness). Results: Our study revealed statically significant increase serum level of homocysteine, carotid intima media thickness and carotid stiffness in children on monotherapy of old generation antiepileptic drugs and poly therapy than that in children on monotherapy of new generation antiepileptic drugs and control. Conclusion: The old generation antiepileptic drugs and polytherapy antiepileptic drugs modalities increase the serum level of homocysteine in children. The new generation antiepileptic drugs have minimal effect on their serum level. Children who use the old generation antiepileptic drugs and polytherapy antiepileptic drugs have increasing in carotid intima media thickness and carotid stiffness than those who use the new generation antiepileptic drugs.

Introduction: Diffusion tensor imaging (DTI) and fiber tractography of the brain plays an important role in evaluation of patients with childhood epilepsy. It shows diffuse white matter abnormalities in patients with pediatric epilepsy. DTI might show the extent of microstructural alterations when the imaging features are normal. Aim of the work: To evaluate the diagnostic value of diffusion tensor MRI and fiber tractography of the brain in detection and characterization of white matter abnormalities in patients with pediatric epilepsy. Patients and Methods: Our study is a prospective study which included 40 pediatric patients with clinical presentation and EEG changes suggesting childhood epilepsy as a case group and 20 subjects as healthy control group. They all referred from pediatric neurology unit to MRI unit at radiology department, Minia University hospital for children, Minia, Egypt, in the period between June 2019 and July 2020. We examined the effects of epilepsy on 15 major WM tracts. We relied on both FA and MD parameters to characterize the integrity of WM tracts in our analysis. These WM tracts include corpus callosum, forceps minor, forceps major, both corticospinal tracts, both uncinate fasciculi, both cingulum (including cingulate gurus part and hippocampal part), both superior longitudinal fasciculi and both inferior longitudinal fasciculi. Results: The case group (N=40) showed significantly low fractional anisotropy (FA) at all examined tracts excepts right cingulum (cingulate gyrus part) and showed high mean diffusivity (MD) at all examined WM tracts except right cingulum (cingulate gyrus part) and right inferior longitudinal fasciculus. Conventional MRI negative group (N=18) showed significantly low fractional anisotropy (FA) at corpus callosum, forceps minor, left corticospinal tract and left inferior longitudinal fasciculus. High mean diffusivity (MD) was noted at corpus callosum, forceps minor, both uncinate fasciculi and both inferior longitudinal fasciculi.

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