Abstract
Background: Patients with epilepsy are at higher risk for atherosclerosis which may be due to epilepsy or antiepileptic drugs. The frequency of atherosclerosis in patients with epilepsy was not previously studied in Egypt. Objective of this study: This study aimed to detect the frequency of subclinical atherosclerosis and some vascular risk factors in patients with idiopathic epilepsy and to correlate it to clinical and laboratory data. Patients and methods: Ninety patients with idiopathic epilepsy and 30 ages, sex matched healthy controls subjected to neurological examination, extra cranial carotid duplex, lipid profile, uric acid and CRP levels. Results: The level of high density lipoprotein cholesterol was significantly lower in all patients with epilepsy and those treated with enzyme inducer antiepileptic drugs than the control subjects. Level of serum uric acid was statistically significantly higher in all patients with epilepsy including the untreated patients and those treated with non-enzyme inducer and poly antiepileptic drugs than control subjects. The Common Carotid Artery Intima Media Thickness (CCA IMT) was significantly higher in all patients with epilepsy including untreated and treated patients with enzyme inducer or non-inducer than control. There was a significant positive correlation between the CCA IMT and duration of illness as well as duration of the antiepileptic drugs. Conclusion: Frequency of subclinical atherosclerosis in the patients with idiopathic epilepsy was 63.33%. The epilepsy itself could result in subclinical atherosclerotic changes in the patients with epilepsy, which could be exacerbated by the antiepileptic drugs, particularly the enzyme inducer drugs.
Highlights
IntroductionEpilepsy is considered one of the most common neurologic disorders worldwide [1], with prevalence ranging from 0.2–4.1% [2].Some studies have found that the risk for heart disease and stroke are increased in patients with epilepsy [3,4].The etiology of atherosclerosis-related vascular diseases in epileptic patients has not been fully clarified; it is possible that epilepsy itself might increase vascular risk, which might be further exacerbated by enzymatically active Antiepileptic Drugs (AEDs) [5].Noninvasive measurement of the Intima Media Thickness (IMT) by high resolution B-mode ultrasound is widely used in the previous studies and validated as a surrogate marker for early prediction of atherosclerosis [6,7].This study aimed to detect the presence of subclinical atherosclerotic changes and some vascular risk factors in the patients with idiopathic epilepsy, and to find out if the atherosclerotic changes are due to the epilepsy itself as a disease or side effects of prolonged use of AEDs, and to correlate atherosclerosis in patients with epilepsy to clinical and laboratory data
The level of high density lipoprotein cholesterol was significantly lower in all patients with epilepsy and those treated with enzyme inducer antiepileptic drugs than the control subjects
The epilepsy itself could result in subclinical atherosclerotic changes in the patients with epilepsy, which could be exacerbated by the antiepileptic drugs, the enzyme inducer drugs
Summary
Epilepsy is considered one of the most common neurologic disorders worldwide [1], with prevalence ranging from 0.2–4.1% [2].Some studies have found that the risk for heart disease and stroke are increased in patients with epilepsy [3,4].The etiology of atherosclerosis-related vascular diseases in epileptic patients has not been fully clarified; it is possible that epilepsy itself might increase vascular risk, which might be further exacerbated by enzymatically active Antiepileptic Drugs (AEDs) [5].Noninvasive measurement of the Intima Media Thickness (IMT) by high resolution B-mode ultrasound is widely used in the previous studies and validated as a surrogate marker for early prediction of atherosclerosis [6,7].This study aimed to detect the presence of subclinical atherosclerotic changes and some vascular risk factors in the patients with idiopathic epilepsy, and to find out if the atherosclerotic changes are due to the epilepsy itself as a disease or side effects of prolonged use of AEDs, and to correlate atherosclerosis in patients with epilepsy to clinical and laboratory data. Some studies have found that the risk for heart disease and stroke are increased in patients with epilepsy [3,4]. The etiology of atherosclerosis-related vascular diseases in epileptic patients has not been fully clarified; it is possible that epilepsy itself might increase vascular risk, which might be further exacerbated by enzymatically active Antiepileptic Drugs (AEDs) [5]. This study aimed to detect the presence of subclinical atherosclerotic changes and some vascular risk factors in the patients with idiopathic epilepsy, and to find out if the atherosclerotic changes are due to the epilepsy itself as a disease or side effects of prolonged use of AEDs, and to correlate atherosclerosis in patients with epilepsy to clinical and laboratory data. Patients with epilepsy are at higher risk for atherosclerosis which may be due to epilepsy or antiepileptic drugs. The frequency of atherosclerosis in patients with epilepsy was not previously studied in Egypt
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