562 https://oamjms.eu/index.php/mjms/index
Scientifc Foundation SPIROSKI, Skopje, Republic of Macedonia
Open Access Macedonian Journal of Medical Sciences. 2023 May 23; 11(B):562-564.
https://doi.org/10.3889/oamjms.2023.11617
eISSN: 1857-9655
Section: B - Clinical Sciences
Category: Neurology
The Hematology Profles of Adults Afliated with Epilepsy after
Receiving Valproic Acid Therapy
Christiyan Naydenov* , Ivan Mindov
Department of Neurology and Psychiatry, Trakia University, Stara Zagora City, Bulgaria
Abstract
AIM: Epilepsy is a socially signifcant neurological disease spread all over the world. Valproic acid (VPA) is one of
the most used antiepileptic drug (AED) for treatment which has some side efects on hematology feld. A nowadays
update to the adult safety information is needed. The current aim is to conduct a cross-sectional study and to
describe the hematology profle of adults with epilepsy treated by VPA.
MATERIALS AND METHODS: Data collection was done retrospectively and includes characteristics of the subjects
such as age, gender, electroencephalography (EEG) fnding, duration of VPA treatment, type of treatment, and
hematology profle. We report 50 subjects treated by VPA at least 1 year.
RESULTS: The mean age is 46, 4 years, 50% male and 50% female. About 92% were generalized tonic-clonic
seizure. Seven percent were partial complex epilepsy. Twenty-four EEG results were abnormal (48%). We found
4 cases (7%) of thrombocytopenia at therapeutic dose and 8 cases (16%) of mild anemia.
DISCUSSION: Gender diferences were eliminated by having the same number of participants of each gender. The
EEG fndings were almost equally normal and abnormal. Reported drug reactions due to VPA were thrombocytopenia
and anemia. Thrombocytopenia requires discontinuation of VPA.
Introduction
Epilepsy is a chronic paroxysmal disease
characterized by a sudden quantitative and/or qualitative
disturbance of consciousness, sensibility, motor activity,
autonomic functions, and psyche. Seizures occur as
a result of hypersynchronous bioelectrical discharges
of neurons in the cerebral cortex. Depending on the
localization of these changes and their distribution,
individual clinical forms difer. Epilepsy is a socially
signifcant neurological disease spread all over the
world. Electroencephalography (EEG) is a way of
graphically recording the electrical potentials of the
brain, supporting the diagnose. It is performed with
a special device - an electroencephalograph [1]. We
determined and grouped the qualitative changes in
the EEG, considering as abnormal only the focal or
generalized epileptic graph elements such as sharps,
spikes, and sharp-and-slow complexes or focuses
of theta and delta rhythms. All other changes in
the type of oscillations, phase amplitude coupling,
phase-to-phase coupling, amplitude-to-amplitude
coupling, cross-frequency phase coupling, and inter-
hemisphere bands are defned as general non-specifc
changes. The normal EEG results are according to the
reference values of the software analysis, reported by
us earlier [1]. Many side efects of valproic acid (VPA)
are related and occur according to the dosage [2]. VPA
is one of the most used antiepileptic drugs (AEDs)
for treatment as frst line which has some known
side efects on hematology feld [3], [4]. A nowadays
update to the adult safety information is needed as
same as the children are already reported [5]. The aim
of current study is to describe the hematology profle
during treatment with VPA.
Materials and Methods
This is a cross-sectional study describing the
hematology profle of epilepsy patients during treatment
with VPA. Data collection was done retrospectively. The
inclusion criteria are adults with epilepsy and use VPA
as the AED at least 1 year. We excluded samples of
patients with known other reasons for deviations of
their hematological status. This study protocol was
reviewed and approved by Local Ethics Committee
of Trakia University - Stara Zagora city, Bulgaria.
Ethical Approval Number: 14 from 02 October 2020.
Since 2002
Edited by: Mirko Spiroski
Citation: Naydenov C, Mindov I. The Hematology
Profles of Adults Afliated with Epilepsy after Receiving
Valproic Acid Therapy. Open Access Maced J Med Sci.
2023 May 23; 11(B):562-564.
https://doi.org/10.3889/oamjms.2023.11617
Keywords: Adults; Epilepsy; Valproic acid;
Hematology profle
*Correspondence: Christiyan Naydenov, Department of
Neurology and Psychiatry, Trakia University,
Stara Zagora City, Bulgaria.
E-mail: kristiyan.naydenov@trakia-uni.bg
Received: 24-Mar-2023
Revised: 26-Apr-2023
Accepted: 22-May-2023
Copyright: © 2023 Christiyan Naydenov, Ivan Mindov
Funding: This research did not receive any fnancial
support
Competing Interests: The authors have declared that no
competing interests exist
Open Access: This is an open-access article distributed
under the terms of the Creative Commons Attribution-
NonCommercial 4.0 International License (CC BY-NC 4.0)