الفهرس | Only 14 pages are availabe for public view |
Abstract A seizure is a transient occurrence of signs and/or symptoms resulting from abnormal excessive or synchronous neuronal activity in the brain. This work aimed at detecting investigate the hepatic toxicity effect of the antiepileptic drugs (AED). This study was carried on 93 children with epilepsy who were referred to Neurology unit, Pediatric department, Zagazig University Hospital, Egypt. In the period from 2014 to 2015 and whose ages ranged from 12 monthes to 15 years old in order to study the hepatic toxicity encountered with regular use of AED. All patients were subjected to Full History Taking, full Clinical Examination, Routine Laboratory investigation (Complete blood count, Liver function tests, PT and PTT), Review of the used medicine duration and doses. Serum level was assessed for Valproate and some patients with carbamazepine; however, it was not available for the new AED. Patients were categorized into three groups according to the type of AED: group A using old drugs, group B using new drugs only and group C using combined old and new drugs. Our results showed that: • The median of age showed statistically non-significant difference between patient groups. The commonest gender incidence is males. • There were non significant difference between group A and group C as regard EEG finding , but there were significant difference between group A and group B & group B & C . • There were non significant difference between between the studied groups in HB level, RBCS count and PT, while there was high statistical significance difference between the studied groups in TLC, platelets count and PTT. • There were statistical significance difference between group A & group B and B,C groups as regarding ALT , while there was no statistical significance difference between group A & group C as regarding ALT. • As regard group A the Comments drug used was sodium valproate (Depakin) with range dose 20-60 mg/kg; duration range of therapy 6-96m; range of drug level 50-170mg/dl. And carbamazepine (tegretol )with dose range 20-25mg/kg; duration range 12-72m, range of drug level 4-17mg/dl. • As regard group B the Comments drug used was levitiracetam (tiratam) with range dose 20-60 mg/kg; duration range of therapy 6-72m. And topiramate( topiamax) with dose range 20-60mg/kg; duration range 12-72m. • As regard group C the Comments drug combinition used was sodium valporate (depakine) & levitiracetam (tiratam) with range dose 20-60 mg/kg for depakine and 15-60 mg/kg for tiratam; duration range of therapy 12-84 m for depakine and 6-84 m for tiratam. While sodium valporate (depakine) & topiramate (topiamax) with dose range 20-60 mg/kg for depakine; 20-30 mg/kg for topiamax with duration range 24-96m for depakine and 12-36 m for topiamax. Then depakine & tegrettol & tiratam with range Dose 20-60 mg/kg for depakine and 10-25 mg/kg for tegrettol and 20-60 mg/kg for tiratam; with range duration of therapy 24-120m for depakine; 24-120 m for tegrettol and 6-36 m for tiratam . Then depakine & tegrettol & topimax with range Dose 20-60 mg/kg for depakine and 15-20mg/kg for tegrettol and 20-25 mg/kg for topimax; with range duration of therapy 108-120m for depakine; 24-108m for tegrettol and 12-60m for topimax. • There were statistical significance difference between group A & group B and B,C groups as regarding Liver function tests, while there were no statistical significance difference between group A & group C as regarding Liver function tests . • There were positive correlation between Depakin drug level and liver function tests in group A and positive correlation between Tegretol drug level and liver function tests. • There were negative correlation between Dose of tiratam and liver function tests in group B and positive correlation between topimax and liver function tests. |