Effect of Antiepileptic Drugs on Liver Function Tests and Lipid Profile in Paediatric Age Group in Okhla Industrial Area

ABSTRACT

Epilepsy is the fourth most common neurological disease and affects people of all ages. There are 150,000 new cases of epilepsy every year.The highest incidence of epilepsy in children coupled with the need of long-term antiepileptic treatment could lead to alterations in haemato-biochemical parameters at an early age. Phenytoin and valproic acid are commonly used antiepileptic drugs in children. This study was aimed to assess the serum lipid profile and liver function tests in children with epilepsy on phenytoin or valproic acid monotherapy for 6 months and their control counterparts. Methods: This case control study recruited children from the pediatric outpatient department of Esic Hospital, Okhla. All consecutive children diagnosed with epilepsy as per International League against Epilepsy definition on phenytoin or valproic acid monotherapy for 6 months were enrolled along with the percentage distribution of type of seizures they were suffering. After baseline clinical and anthropometric evaluation (including body mass index [BMI]), the fasting blood samples were analyzed for serum lipid profile and liver function changes. Results: Total of 133 children were enrolled. There were 42 and 36 patients in phenytoin and valproic acid groups respectively and 55 in normal healthy control group. We observed statistically significant high mean total cholesterol and alkaline phosphatase levels in group receiving phenytoin when compared with valproic acid or control group. Conclusion: The lipid and liver enzyme abnormalities may be observed in children on phenytoin or valproic acid therapy, which warrants careful screening and monitoring as young children have immature detoxification mechanisms and a greater variability in dosing owing to a wider range of body size and weight. New epilepsy research should be integrated in areas i.e. Genomics, neuroimaging, neuropsychology and neuropathology for better understanding of the disease and to improve the global health outcomes.