Estimation of Serum Level of Homocysteine and its Potential Cardiovascular Effect in Epileptic Children Receiving Antiepileptic Drugs

Abstract

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.