Evaluation of Extra and Intra Cerebral Blood Vessels by Ultrasonographic Studies in Epileptic Patients on Valproic Acid in Comparison to Patients on Levetiracetam

Abstract

Background: This study aims to evaluate the extra and intra cerebral blood vessels   in epileptic patients on valproic acid versus patients on levetiracetam 

Methods: One hundred participants were diagnosed with idiopathic epilepsy in accordance with ILAE standards and were categorized into Group A (VPA - 50 patients) and Group B (levetiracetam - 50 patients). A control group of 50 healthy individuals was also included.   Participants underwent a comprehensive clinical assessment, Anthropometric Measurements (weight, height, BMI) ,  serum lipid profile, EEG, and cerebral blood vessels were evaluated through Extracranial carotid duplex sonography for Carotid Intima-Media Thickness (CIMT) measurements and Transcranial Color-Coded Duplex (TCCD).

Results:  there was an increase in Body Mass Index (BMI) and weight in the VPA group, which were significantly higher in comparison to both the levetiracetam and control groups (p ≤ 0.001). Also, VPA treatment therapy corresponded with markedly elevated triglyceride levels and significantly lower HDL levels compared to both levetiracetam and control groups (p ≤ 0.001 and p ≤ 0.05, respectively). CIMT measurements were significantly increased in the VPA group (0.08 ± 0.02 cm) compared to the levetiracetam (0.05 ± 0.01 cm) and control groups (0.05 ± 0.01 cm) (p ≤ 0.001). However, TCCD parameters (PSV, EDV, MFV, and PI) showed no significant differences among the studied groups. 

Conclusion:  Our study points out that VPA may contribute to weight gain, increased BMI, altered lipid profiles, and increased CIMT, suggesting the need for careful clinical monitoring and cerebral blood vessel ultrasound assessment in these patients.