Body mass index [BMI] and some hormonal changes in epileptic children receiving antiepileptic therapy

ABSTRACT

Epilepsy is a common neurological problem. It's treatment is often for years or even lifelong. The primary treatment of choice is the use of the antiepileptic drugs [AEDs]. Endocrine disorders are of major concern for clinicians who treat patients with epilepsy. This prospective hospital based study was conducted during the period from March 2008 till November 2010 at Assiut Children University Hospital. The aim of the study was to assess the effect of some antiepileptic drugs is Valproic acid, Carbmazepine or Topirmate, either monotherapy in combination on body weight and some endocrine aspects in epileptic children. The study included 62 epileptic children and 25 age and sex matched normal children as control. The cases were divided into 4 groups [Group 1] included 22 cases on Valproic acid alone, [Group 2] included 19 cases on Valproic acid and Carbmazepine, [Group 3] included 21 cases on Valproic acid and Topirmate and control cases [Group 4]. All children were subjected to detailed medical history, full neurological examination, measurement of height, weight and body mass index [BMI], in addition to estimation of serum levels of leptin, insulin and fasting blood glucose levels. Patients treated with Valproic acid alone [group1] had significantly increased BMI and serum levels of leptin and insulin when compared with either [group3] or [group 4]. Cases on both Valproic acid and Carbmazepine [group 2] had significantly higher serum level of leptin, insulin and BMI when compared with control group [group 4].Cases on both Valproic acid and Topiramate had significantly higher serum level of insulin when compared with control group [group 4].Serum level of leptin in cases treated with Valproic acid had positive correlation with age, BMl,insulin, dose and treatment duration. Cases of obese parents had increased BMI, serum leptin and insulin when compared with cases of non obese parents. The study concluded that children receiving antiepileptic medications especially valoproic acid are at a great risk for development of obesity especially if associated with other risk factors as female sex and obese parents. Leptin and insulin serum levels should be checked regularly during treatment with antiepileptic drug therapy especially Valproic acid