Effect of Antiepileptic Drugs on Plasma Carnitine Level in Children with Idiopathic Epilepsy

Abstract
Background: Prolonged antiepileptic drugs treatment can result in secondary carnitine deficiency. Clinical studies indicate a decrease in total and free plasma carnitine level in children treated with old antiepileptic drugs especially val-proate.
Aim of Study: Was to evaluate the plasma carnitine level in children with idiopathic epilepsy treated with old antiepi-leptic drugs (valproate and carbamazepine) and new antiepi-leptic drugs (leviteracetam and oxcarbazepine).
Patients and Methods: This study was a prospestive study including 50 patients with newly diagnosed idiopathic epilepsy classified into four groups according to their antiepileptic drug treatment into: Group 1, 20 patients received valproic acid. Group 2, 10 patients treated with carbamazepine. Group 3, 10 patients treated with leviteracetam. Group 4, 10 patients treated with oxcarbazepine. The study was carried out in duration of 1 year from January 2017 to January 2018.
Results: There was significant difference between mean plasma level of carnitine in children treated with valproate and the controls. There was inverse correlation between the duration of treatment with valproate and the mean plasma carnitine level. There was inverse correlation between the level of valproate and the mean plasma carnitine level. The higher the level of valproic acid, the more significant decrease in the mean plasma carnitine level.
Conclusion: Valproic acid was the only antiepileptic drug reported to cause carnitine deficiency. Also this study showed inverse correlation between plasma carnitine level and duration of treatment with valproic acid. The longer the duration of treatment, the more significant decrease in mean plasma carnitine level. Also, there was inverse correlation between the level of valproate and the mean plasma carnitine level. The higher the level of valproic acid, the more significant decrease in the mean plasma carnitine level.