Article

Whether new antiepileptic drugs (AEDs) may result in neuropathy is unknown but possible given their effects on vitamin metabolism. This analysis
aimed to determine frequency and correlates of neuropathy in subjects treated
with new AEDs in relation to drug used, length of exposure and serum vitamin B12
and folate levels. METHODS:
We performed a cross-sectional study of 52
consecutive epileptic subjects. Presence of neuropathy was determined using the
Utah Early Neuropathy Score (UENS). Exposure to anti-epileptic drugs was
quantified. Serum vitamin B12 and folate levels were measured. RESULTS: Commonly
used AEDs were levetiracetam (28/52), carbamazepine (20/52), lamotrigine (20/52),
sodium valproate (10/52) and zonisamide (10/52). Eight of 52 (15.4%) patients had
neuropathy. There was no association with any particular AED. Neuropathy
correlated with age (P=0.038) and total exposure to AEDs (P=0.032). UENS
correlated with age (P=0.001), total AED exposure (P=0.001) and serum vitamin
B12<240ng/L (P=0.018). Independent association of neuropathy was found with total
AED exposure (P=0.032), but not age. UENS was independently associated with total
exposure to AEDs (P<0.001), vitamin B12<240ng/L (P=0.002), but not age. Serum
vitamin B12 and folate levels were highly inter-correlated (P<0.001).
CONCLUSIONS: Neuropathy appears to be associated with the length of exposure to
new AEDs. This may relate to the effects of new AEDs on vitamin B12 and folate
metabolism. Although further research from controlled studies is needed and
despite the presence of other possible confounding factors, monitoring for
neuropathy and vitamin B12 and folate levels merits consideration in patients on
long-term treatment with new AEDs.
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Langue : ANGLAIS