Background: There are numerous reports about the adverse effects of ANTIEPILEPTIC DRUGS (AED) on bone metabolism. This study was designed to evaluate these effects in children and adolescents. Methods: We compared bone metabolism in children and adolescences 4-15 years old who were treated for 6 month with AED compare with a control group at the same age. Bone metabolism was evaluated by measurement of serum calcium, phosphorus, alkaline phosphates (ALP) and parathormone (PTH) in both group. Findings: 119 patients and 119 controls were studied during a 20 months period. Normal serum calcium and phosphorus levels were observed in 96.6% and 93.3% of cases respectively. Serum alkaline phosphatase was normal in 76.5% of patients while raised levels were observed in the remaining 23.5%. PTH was normal in 77.3% of patients and increased in 18.5 % of cases. Serum ALP and PTH level were significantly higher than control group (P=0.00). Highest ALP and PTH levels were seen in carbamazepine consumers while patients on sodium valproate showed the least rise. Conclusions: Periodic measurements of calcium, phosphorus, ALP, and specially PTH is recommended for the evaluation of bone metabolism in long-term treatment with AED, including sodium valproate.

Objective: As epilepsy and seizure disorders are common in children, ANTIEPILEPTIC DRUGS are used more commonly in this age group than in adults. This study was carried out in order to determine the vitamin D and calcium status of children receiving ANTIEPILEPTIC DRUGS and evaluation of effects of these DRUGS on vitamin D and calcium metabolism. Material & Methods: Sixty epileptic children and adolescents visiting Children's Neurology Clinic who were taking ANTIEPILEPTIC DRUGS and had inclusion criterions were selected as simple sampling from July 2005 to June 2006. Thirty age and sex matched normal children and adolescents were considered as control group. Serum levels of 25OHD3, calcium and alkaline phosphatase is compared between groups. Findings: Serum levels of 25OHD3 (P<0.001), calcium (P<0.001) and alkaline phosphatase (P<0.001) were significantly different between groups. Ten percent of patients had serum 25OHD3 level below lower normal limit. There was a reverse correlation between duration of drug therapy and serum level of 25OHD3 (r=-0.345, P=0.011).Conclusion: ANTIEPILEPTIC drug treatment in children results in reducing serum 25OHD3 and calcium levels and increases bone turnover. With longer duration of treatment serum 25OHD3 level decreases more.

Background and purpose: Anti-epileptic DRUGS (AEDs) can affect cognitive functions. The purpose of this study was to investigate the effects of lamotrigine (LT) on cognitive functions of patients with epilepsy. Materials and methods: A study with retrospective cohort design was carried out in which we assessed cognitive functions of 20 IGE patients attending Sari Bu Ali Hospital, and 12 healthy subjects. The control group was matched for age, sex, and educational level. Standardized neuropsychological tests were used to evaluate cognitive functions. The study was analyzed applying one-way ANOVA and Tukey Test in SPSS. Results: Compared with the control group, LT group showed poor performance in Stroop test and verbal fluency test-semantic test (P<0. 05). The group on other DRUGS were also found to have poor performance in verbal fluency test (phonetic and semantic), forward digit span task, and Stroop test compared with those of the control group (P<0. 05). Conclusion: Compared with LT, other AEDs had more adverse effects on cognitive functions which could be due to their effect on channels and release changing stimulatory neurotransmitters.

ANTIEPILEPTIC DRUGS are mainstay of epilepsy treatment. Recently the numbers of ANTIEPILEPTIC DRUGS have increased. Most patients with epilepsy are controlled by a single ANTIEPILEPTIC drug well. Some of patients that controlled have medication side effects and occasional seizures. Approximately 30% of patients with partial epilepsy and 25% of patients with generalized epilepsy are not well controlled by ANTIEPILEPTIC DRUGS. These patients are often receiving multiple ANTIEPILEPTIC DRUGS, and have disabling seizure and side effects. Second generations (newer) of ANTIEPILEPTIC DRUGS are safer and better tolerated than the older ANTIEPILEPTIC DRUGS, but this is not enough for epileptic patients. In a big study with established ANTIEPILEPTIC DRUGS, 40% of patients that uncontrolled with a single drug can be controlled better by two DRUGS, but 9% of these patients became free seizures. A meta-analysis showed when newer ANTIEPILEPTIC DRUGS add to older, can be controlled 12-29% more than before in patients and reduced 50% of rate of epileptic attacks. Surgery and Vagus nerve stimulation are important in refractory epileptic patients. Children, elderly, women and patients with developmental delays need special considerations.