International Journal of Contemporary Pediatrics | July-August 2017 | Vol 4 | Issue 4 Page 1369 International Journal of Contemporary Pediatrics Ksoo R et al. Int J Contemp Pediatr. 2017 Jul;4(4):1369-1373 http://www.ijpediatrics.com pISSN 2349-3283 | eISSN 2349-3291 Original Research Article The effects on carotid artery intima-media wall thickness and development of atherosclerosis in children on anti-epileptic drug monotherapy Rosina Ksoo 1 *, Rakesh Sharma¹, R. K. Kaushal¹, Anupam Jhobta² INTRODUCTION Seizures are common in the pediatric age group and occur in ≈10% of children. About 70-80% of the patients who develop epilepsy may expect to have their seizures controlled with optimal antiepileptic therapy. The cumulative lifetime incidence of epilepsy is 3% and more than half of the cases begin in childhood. However, the annual prevalence of epilepsy is lower (0.5-0.8%) because many children outgrow epilepsy. 1 Epidemiological, clinical and experimental investigations have shown that anti-epileptic drugs (AED) predispose to atherosclerosis by altering the lipid profile. 2 It has been well documented that atherosclerotic vascular alterations may start early in life and progress with age. 3 The first signs of hyperlipidemia can be detected in childhood and fatty streaks, which are the earliest pathologic lesions of atherogenic process, can be observed in the aorta and coronary arteries of individuals by the age of 20. 4,5 Non- invasive measurement of carotid intima-media thickness 1 Department of Paediatrics, 2 Department of Radiodiagnosis, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India Received: 28 March 2017 Accepted: 27 April 2017 *Correspondence: Dr. Rosina Ksoo, E-mail: rksoo.91@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. ABSTRACT Background: Children with seizure disorder and requiring long-term anti-epileptic drugs are predisposed for development of atherosclerosis. We monitored the carotid artery intima wall thickness of the children on Anti- epileptic drug monotherapy along with their lipid profile for a period of one year. Methods: Children under 18 years, who were newly diagnosed with epilepsy or were already on anti-epileptic drug monotherapy were included in the study period of one year. They were then prospectively followed-up at three months and again between the sixth and twelfth month’s period. A high-resolution B-mode ultrasound using a 5-7 MHz linear transducer was employed for measuring the thickness of the carotid intima-media thickness (cIMT). The biochemical parameters including fasting lipid profile, body mass index and dietary habits were also taken. Results: A total of 130 children were included in the study. The values of cIMT observed were 0.38 mm (0.1 mm) and 0.41 mm (0.1mm) in the new (control) and old cases respectively. The values of cIMT were significantly increased in patients receiving Carbamazepine (CBZ) and Phenytoin after 3 months of therapy and with increase in age and duration of intake of anti-epileptic drugs. There were no gender differences in the value of cIMT. Conclusions: The values of serum cholesterol, LDL and HDL were significantly increased in children on CBZ and valproic acid. There was no difference in the lipid profiles of children on Phenytoin and Phenobarbitone. However, the atherogenic indices of the children taking any of the four anti-epileptic drugs were normal. Keywords: Anti-epileptic drugs, Atherosclerosis, Carotid IMT, Monotherapy, Seizure DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20172668