Side Effects of Antiepileptic Drugs in Children: A Review | Helpful Guide for Families

1. Side Effects of AntiepilepticDrugsUsed in ChildrenwithEpilepsy: A SystematicReview *Assist. Fatma Dilek TURAN GÜRHOPUR *Assoc. Prof. Ayşegül İŞLER DALGIÇ *AKDENİZ UNIVERSTY, NURSING FACULTY

2. AntiepilepticDrugs in Epilepsy Althoughtherearealternatives in thetreatment of epilepsy, theprimarytreatment is antiepilepticdrug (AED) treatment. However, AED treatment has sideeffects. This is moreserious in children.

3. OBJECTIVE Theobjectiveof thissystematicreviewwastodeterminethesideeffects of antiepilepticdrugsused in childrenwithepilepsy.

4. Meterial and Method

5. MeterialandMethod-II

6. MeterialandMethod-III

7. RESULTS

8. Themostfrequentsideeffects in childrenwhousedantiepilepticdrugs in thestudiesstudiedwere; -Weightgain, -Body massindexand serum glucoselevels, -Gingivalproblems, -Hearingproblemsand -High renaltubuleswerenoted as disfunctions.

9. Hasaneenet al. (2016), there was no significant difference between anthropometric measurements, BMI and blood test and control groups when the results were compared. However, in the experimental group, it was determined that waist-to-hip ratio and neck significantly increased when severe weight loss and decrease in BMI were detected after 6 months of levetiracetam treatment compared to pre-treatment values.

10. Maksoud et al. (2016) did not show a statistically significant difference in terms of weight, height and BMI between the groups when the results were compared. However, the increase in weight and BMI at the 6th and 1 st follow-ups of the experimental group was statistically significant. Serum calcium levels were not significantly different between the two groups, whereas serum glucose levels were found significantly higher in the 6th month and 1st year follow-up of the experimental group. Similarly, while the AST values in the experimental group did not differ across the follow-ups, ALT values increased significantly throughout the follow-up.

11. Suneja et al. (2016), Phenytoin has beenreportedtocausegingivalhyperplasia. Sodiumvalproate has beenreportedtohavegingivalhyperplasiatoclinicallyinsignificantlevelswithinsixmonths, andcarbamazepine has beendescribed as a safedrug in childrenwithgingivalhyperplasia. Therewasnosignificantdifferencebetweenmeanplaquescores at baseline, at 3 months, and at 6 months in allthreedruggroups.

12. Mazaheri et al. (2011), there was no significant difference in renal dysfunction between the control group and the non-antiepileptic drug-initiated group. NAG activity, a finding of renal dysfunction, was found to be statistically significantly higher in the valproic acid group than in the two drug-free groups. The urinary NAG / Creatinine index was significantly higher in the carbamazepine-receiving group compared with the non-drug-treated group. However, when NAG / Cr indices were examined between two groups using drugs, the NAG / Cr index of children in the group receiving valproic acid was statistically significantly higher. In addition, plasma concentrations of other renal dysfunction were found to be statistically significantly higher in these two groups.

13. Vurucu et al. (2008) assessed their hearing function according to the results of BSİUP test, and stated that there was no statistically significant difference between the groups in terms of I, III, V and I-III, I-V interpeak latency values. When the patients with valproic acid and carbamazepine groups were compared with the control group in terms of BSIP wave and interpeak latency values, the patients with both valproic acid and carbamazepine groups were statistically significant in terms of BSIP pulse I, III, V and I-III, IV interpeak latencies was longer. However, there is no significant difference between the patients with valproic acid and carbamazepine groups in terms of baseline wave and interpeak latencies.

14. CONCLUSION Thestudyresultsshowthatfamilyandchildrenshould be informedaboutthedefinitesideeffects of antiepilepticdrugsandawarenessshould be developed in thisregard.

15. SUGGESTIONS Knowing the side effects of AEDs is very important because they are taken into account in deciding on the use of AEDs in the clinic and awareness should be set up in the families. It is proposed to systematize the drugs with definite side effects by standardization and to share these side effects with children and parents bya guide.

16. SUGGESTIONS However, when the family is informed about side effects of drugs, it should be explained how important epilepsy drug treatment is. Otherwise, many families may think that AEIs have more adverse side effects than treatment and that they are harmful to the child.

17. REFERENCES • Hasaneen, B., Salem, N. A., El Sallab, S., Elgaml, D., & Elhelaly, R. Body weight, body composition, and serum ghrelin in epilepticchildrenreceivinglevetiracetammonotherapy. EgyptianPediatricAssociationGazette, 2016; 64(4), 154-159. • Maksoud, H. M. A., El-Shazly, S. M., & El Saied, M. H. Effect of antiepilepticdrug (valproicacid) on childrengrowth. EgyptianPediatricAssociationGazette, 2016;64(2), 69-73. • Suneja, B., Chopra, S., Thomas, A. M., & Pandian, J. A Clinical Evaluation of GingivalOvergrowth in Children on AntiepilepticDrugTherapy. Journal of clinicalanddiagnosticresearch 2016;10(1), ZC32. • Mazaheri, M., Samaie, A., & Semnani, V. Renaltubulardysfunctionmeasuredby N-acetyl-beta glucosaminidase/Creatinineactivityindex in childrenreceivingantiepilepticdrugs: a randomizedcontrolledtrial. ItalianJournal of Pediatrics 2011; 37(1), 21. • Vurucu, S., Kesik, V., Ünay, B., Ulaş, Ü. H., Odabaşı, Z., & Akın, R. Uzun süreli antiepileptik ilaç tedavisinin beyinsapı işitsel uyarılmış potansiyelleri üzerine olan etkisi ve klinik önemi, 2008