Controlled evaluation of serum lipid levels and carotid artery intima media thickness in idiopathic epileptic children treated with valproic acid

Objective: It is aimed to evaluate the tendency for atherosclerosis in idiopathic epileptic children treated with valproic acid by measuring the serum cholesterol levels and carotid artery intima media thickness which is thougt to be the indirect marker of subintimal lipid deposition.Methods: 44 idiopathic epileptic patients aged between 7 to 18 years, being followed in Pediatric Neurology Department of Dokuz Eylül University School of Medicine, who are treated with valproic acid at least for one year and 40 healthy children with similar characteristics as age and sex were included for the study.Serum concentrations of triglyceride, total cholesterol, high density lipoprotein (HDL), low density lipoprotein (LDL) were measured in all patients. Intima media thickness measurements were performed in similar position from two cm. proximal of left main carotid artery bulbus in all patients.Patients with hypertension, history of smoking, diabetes mellitus, familial hypercholesterolemia, family history of early atherosclerosis, chronic illness aside from epilepsy, relative weigth>120% (obese) were not included for the study.Results: Among the epileptic patients of the study group, 39 (88%) had generalized epilepsy and 5 (12%) had focal epilepsy.Among the patient group treated with valproic acid, there were 26 (59%) male and 18 (41%) female patients and the control group consisted of 21 (52.5%) male and 19 (47.5%) female patients. The mean age of the patient group was 11.1±3.2 years and it was 11.6±3.1 years for the control group. No statistically significant difference was detected between the epileptic children of the study and the healthy control group in respect to age and sex distrubution (P>0.05).There was no statistically significant difference between the patient and control group in respect to serum cholesterol levels and weight for height percentages (P>0.05).The patients were divided into two groups in respect to their therapy duration with valproic acid as 12-24 months and more than 24 months. There was no statistically significant difference between the measurements of intima media thickness between these groups (P=0.611).The intima media thickness measurements of the healthy control group and valproic acid treated epileptic patients group were compared and there was statistically significant difference between the groups (P=0.001).Conclusion: A significant increase in carotid artery intima media thickness was shown in patients treated with valproic acid even there is no considerable change in serum cholesterol levels. Since atherosclerosis starts in childhood and its clinical signs appear in advancing ages, similar and larger studies for the necessity of periodic ultrasonographic measurement of carotid artery intima media thickness in idiopathic epileptic patients treated with valproic acid will be beneficial.Key words: Valproic acid, idiopathic epilepsy, atherosclerosis, intima media thickness