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Short-Term Side Effects of Low Dose Valproate Monotherapy in Epileptic Children: A Prospective Study Publisher



Esfahani PN1 ; Nasiri J2 ; Badihian S1, 2 ; Yaghini O2
Authors
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Authors Affiliations
  1. 1. Students’ Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Iranian Journal of Child Neurology Published:2019


Abstract

Objectives Considering the common use of valproate among children, we investigated the short-term side-effects of low dose valproate monotherapy in epileptic children. Methods In this prospective study, 209 epileptic children (48.3% male, mean age: 7.02 ± 3.13 yr) on low therapeutic dose of valproate monotherapy (20-30 mg/kg/d) were enrolled during 2014-2015 in Isfahan Pediatric Neurology Clinic, Isfahan University of Medical Sciences, Isfahan, Iran and side-effects were evaluated through frequent clinical visits and laboratory tests during 6 months of valproate therapy. Results Weight gain was reported in 53.1% of patients. Decreased appetite was seen in 11% of patients, more frequent in younger cases (P=0.006). Abdominal pain, nausea/vomiting, diarrhea, and constipation were reported in 16.3%, 2.4%, 1.4%, and 1% of patients, respectively. Headache, tremor, dizziness, abnormal color vision, myoclonus, and bruxism were seen in 5.7%, 1.4%, 1%, 1%, 1%, and 0.5% of patients, respectively. Enuresis, hair loss, and skin rash were reported in 8.1%, 6.7%, and 0.5% of patients, respectively. Thrombocytopenia, impaired liver function tests, and leukopenia occurred in 1%, 1%, and 0.5% of patients, respectively. Conclusion Low dose valproate monotherapy may cause numerous side-effects, mostly not life-threatening and requiring no action. Beside other reported complications, we observed decreased appetite (among younger patients), enuresis, and abnormal color vision which are only briefly discussed in the literature and need to be addressed more. © 2019, Iranian Child Neurology Society. All rights reserved.