Vestibular function in children with generalized epilepsy and treated with valproate

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.

Automated summary

Vestibular dysfunctions are common in children with epilepsy, with bilateral peripheral dysfunction being more prevalent than central dysfunction, suggesting a potential adverse effect of valproate on the vestibular system.