Impact of carbamazepine on postural control in older adults: an exploratory study

Abstract

Objective To explore whether carbamazepine impairs postural control in older people with epilepsy. Design Measures at 0 hours, before ingesting carbamazepine (baseline), and 2, 4 and 6 hours thereafter. Setting Rehabilitation laboratory. Participants Patients, aged 55 years or more, taking carbamazepine for epilepsy ( n = 4) and age-matched healthy volunteers ( n = 2). Measures (1) Heel-to-toe walk: walking speed, double support time and hand excursion. (2) Standing still, eyes open/closed: centre of mass excursion. (3) Sit-to-walk: duration of task and component phases. Results (1) Heel-to-toe. Three patients completed the task. At baseline, double support time was 150% and hand excursion was 65% of volunteer values. Walking speed did not differ. Patients showed no change over time. (2) Standing. At baseline, patients’ centre of mass excursion was 294% (eyes open) and 288% (eyes closed) of volunteer values. Patients showed no change over time. (3) Sit-to-walk. At baseline, no difference was observed in task duration between patients and volunteers. Patients took 42% longer for flexion momentum, 59% less time for unloading and 219% longer for stance phases. Over time, patients took longer for flexion momentum (208% of volunteer values at 6 hours, 142% of volunteer values at baseline) and extension (190% of volunteer values at 2 hours, 126% of volunteer values at baseline). Conclusions Older people with epilepsy taking carbamazepine could have postural control deficits. Further investigation is justified.