Vestibular function in children with generalized epilepsy and treated with valproate

ABSTRACT

Background

Studies that evaluated vestibular function with epilepsy are fewer than auditory studies. We assessed vestibular function in children with epilepsy in inter-ictal period.

Research design and methods

This cross-sectional study included 35 children with generalized epilepsy (boys=15; girls=20; age=11.20±1.21 years; epilepsy duration=3.54±1.80 years) and treated with valproate (VPA) and 24 healthy children. Vestibular evaluation was conducted using videonystagmography (VNG) and cervical vestibular evoked myogenic potentials (cVEMPs).

Results

Dizziness was the vestibular symptom in 22.86% of cases. Vestibular dysfunctions (VDs) were found in 65.71%. Manifestations of peripheral VD (65.71%) included unilateral caloric weakness and reduced cVEMP amplitudes. Manifestations of central VD (28.57%) included oculomotor abnormalities, positional nystagmus with normal calorics, and prolonged cVEMPs latencies. Significant correlations were found between VDs and duration of epilepsy and its treatment [r = −0.368, P=0.01] and VPA dose [r = −0.286, P=0.02] and level [r = −0.355, P=0.01]. Logistic regression analysis showed that duration of epilepsy and its treatment [OR = 3.55 (95% CI = 2.54–6.50), P=0.001] were independently associated with VDs.

Conclusions

VDs are common in children with epilepsy. Bilateral peripheral VD was more common than central VD, suggesting an adverse effect of VPA. However, epilepsy cannot be excluded as a cause of central VD.

KEYWORDS:

• Epilepsy
• children
• valproate (VPA)
• videonystagmography (VNG)
• cervical vestibular evoked myogenic potentials (cVEMPs)

Acknowledgments

This work has been previously presented as an oral presentation at the 3rd International conference on PharmaScience Research and Development (Pharma R&D during), February 22–24, 2021 (https://pharma-rd.com/).

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Author contributions

All authors (SA Hamed and AM Oseily) have substantially contributed to the conception and design of the article and interpreting the relevant literature, and been involved in writing the article and revised it for intellectual content.

Abbreviations

VPA, valproate; VNG, videonystagmography; cVEMPs, cervical vestibular evoked myogenic potentials; VDs, vestibular dysfunctions; ASM, antiseizure medicine; CBZ, carbamazepine; ENG, electronystagmography; SCM, sternocleidomastoid; AR, asymmetry ratio; OKN, optokinetic; GABA, gamma-aminobutyric acid

Additional information

Funding

This paper was not funded.