Assessment of carotid-intima media thickness in patients with epilepsy receiving antiepileptic drugs

Year 2022, Volume: 5 Issue: 1, 234 - 238, 17.01.2022

Mehtap Kocatürk , Özcan Kocatürk

https://doi.org/10.32322/jhsm.1006178

Abstract

Aim: This study aims to investigate whether there is an increase in carotid-intima media thickness (C-IMT) in epilepsy patients using antiepileptic drugs when compared to the normal control group and whether there is a difference when we group them as monotherapy and polytherapy.
Material and Method: 68 people were included in the prospective cross-sectional study. 38 epilepsy and 30 healthy control groups that were matched in terms of demographic characteristics
Results: C-IMT was statistically higher in the epilepsy group (p<0.001). When carotid USG results are analyzed as control, monotherapy, and polytherapy, there was no difference between control and monotherapy, there was statistical significance between the control group and polytherapy (p<0.001), and between monotherapy and polytherapy (p:0.010)
Conclusions: According to our study result, polytherapy should be avoided as much as possible, especially in patients with vascular risk factors.

Keywords

Carotid-Intima media thickness, Epilepsy, Monotherapy-Polytherapy

References

• Ngugi AK, Bottomley C, Kleinschmidt I, Sander JW, Newton CR. Estimation of the burden of active and lifetime epilepsy: a meta-analytic approach. Epilepsia 2010; 51: 883-90.
• Shen C, Chen F, Zhang Y, Guo Y, Ding M. Association between use of antiepileptic drugs and fracture risk: a systematic review and meta-analysis. Bone 2014; 64: 246–53.
• Eddy CM, Rickards HE, Cavanna AE. Behavioral adverse effects of antiepileptic drugs in epilepsy. J Clin Psychopharmacol 2012; 32: 362-75.
• Mintzer S. Metabolic consequences of antiepileptic drugs. Curr Opin Neurol 2010; 23: 164-69.
• Perucca P, Gilliam FG. Adverse effects of antiepileptic drugs. Lancet Neurol 2012; 11: 792-02
• Chang CS, Liao CH, Lin CC, Lane HY, Sung FC, Kao CH. Patients with epilepsy are at an increased risk of subsequent stroke: a population-based cohort study. Seizure 2014; 23: 377-81.
• Hsieh CY, Lai EC, Yang YH, Lin SJ. Comparative stroke risk of antiepileptic drugs in patients with epilepsy. Epilepsia 2013; 54: 172-80.
• Mahmoudian T, Iranpour R, Messri N. Serum lipid levels during carbamazepine therapy in epileptic children. Epilepsy Behav 2005; 6: 257-9.
• Karabiber H, Sonmezgoz E, Ozerol E, Yakinci C, Otlu B, Yologlu S. Effects of valproate and carbamazepine on serum levels of homocysteine, vitamin B12, and folic acid. Brain Dev 2003; 25: 113-5.
• Talaat FM, Kamel T, Rabah AM, Ahmed SM, El-Jaafary SI, Abdelaziz GH. Epilepsy and antiepileptic drugs: risk factors for atherosclerosis. Int J Neurosci 2015; 125: 507-11.
• Hamed SA. Atherosclerosis in epilepsy: its causes and implications. Epilepsy Behav 2014; 41: 290-96.
• Polak JF, Pencina MJ, Pencina KM, O'Donnell CJ, Wolf PA, D'Agostino RB Sr. Carotid-wall intima-media thickness and cardiovascular events. New Engl J Med 2011; 21; 365: 213-21.
• Hermann DM, Gronewold J, Lehmann N, et al. Intima-media thickness predicts stroke risk in the Heinz Nixdorf Recall study in association with vascular risk factors, age and gender. Atherosclerosis 2012; 224: 84-9.
• Scheffer IE, Berkovic S, Capovilla G, et al. ILAE classification of the epilepsies: position paper of the ILAE Commission for classification and terminology. Epilepsia 2017; 58: 512-21.
• Lai Q, Shen C, Zheng Y, Zhang Y, Guo Y, Ding M. Effects of antiepileptic drugs on the carotid artery ıntima-media thickness in epileptic patients. J Clin Neurol 2017; 13: 371-9.
• Mehrpour M, Shojaie M, Zamani B, Gharibzadeh S, Abbasi M. Atherogenic consequence of antiepileptic drugs: a study of intima-media thickness. Neurol Sci 2014; 35: 253-7.
• Karatoprak E, Tosun O. Effects of valproic acid and levetiracetam monotherapy on carotid intima-media and epicardial adipose tissue thickness in non-obese children with epilepsy. Brain Dev 2020; 42: 165-70.
• Calik M, Ozkan HY, Ethemoglu O, et al. The measurement of both carotid intima-media thickness and epicardial adipose tissue thickness in children with epilepsy receiving antiepileptic drug therapy. Epilepsy Behav 2018; 85: 110-4.
• Tan TY, Lu CH, Chuang HY, et al. Long-term antiepileptic drug therapy contributes to the acceleration of atherosclerosis. Epilepsia 2009; 50: 1579-86.
• Erdemir A, Cullu N, Yiş U, et al. Evaluation of serum lipids and carotid artery intima-media thickness in epileptic children treated with valproic acid. Brain Dev 2009; 31: 713-6.