The effects on carotid artery intima-media wall thickness and development of atherosclerosis in children on anti-epileptic drug monotherapy

Abstract

Background: Children with seizure disorder and requiring long-term anti-epileptic drugs are predisposed for development of atherosclerosis. We monitored the carotid artery intima wall thickness of the children on Anti-epileptic drug monotherapy along with their lipid profile for a period of one year.Methods: Children under 18 years, who were newly diagnosed with epilepsy or were already on anti-epileptic drug monotherapy were included in the study period of one year. They were then prospectively followed-up at three months and again between the sixth and twelfth month’s period. A high-resolution B-mode ultrasound using a 5-7 MHz linear transducer was employed for measuring the thickness of the carotid intima-media thickness (cIMT). The biochemical parameters including fasting lipid profile, body mass index and dietary habits were also taken.Results: A total of 130 children were included in the study. The values of cIMT observed were 0.38 mm (0.1 mm) and 0.41 mm (0.1mm) in the new (control) and old cases respectively. The values of cIMT were significantly increased in patients receiving Carbamazepine (CBZ) and Phenytoin after 3 months of therapy and with increase in age and duration of intake of anti-epileptic drugs. There were no gender differences in the value of cIMT.Conclusions: The values of serum cholesterol, LDL and HDL were significantly increased in children on CBZ and valproic acid. There was no difference in the lipid profiles of children on Phenytoin and Phenobarbitone. However, the atherogenic indices of the children taking any of the four anti-epileptic drugs were normal.