Nasr Esfahani Parisa, Nasiri Jafar, Badihian Shervin, Yaghini Omid
Students' Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
Iran J Child Neurol. 2019 Spring;13(2):37-46.
Considering the common use of valproate among children, we investigated the short-term side-effects of low dose valproate monotherapy in epileptic children.
MATERIALS & 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.
Weight gain was reported in 53.1% of patients. Decreased appetite was seen in 11% of patients, more frequent in younger cases (=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.
Low dose valproate monotherapy may cause numerous side-effects, mostly not life-threatening and requiring no action. Besides more reported complications, we observed decreased appetite (among younger patients), enuresis, and abnormal color vision which are onlybriefly discussed in the literature and need to be addressed more.
鉴于丙戊酸盐在儿童中广泛使用，我们调查了低剂量丙戊酸盐单药治疗对癫痫儿童的短期副作用。
在这项前瞻性研究中，2014年至2015年期间，伊朗伊斯法罕医科大学伊斯法罕儿科神经科门诊纳入了209例接受低治疗剂量丙戊酸盐单药治疗（20 - 30mg/kg/d）的癫痫儿童（男性占48.3%，平均年龄：7.02±3.13岁），在丙戊酸盐治疗的6个月期间，通过定期临床访视和实验室检查评估副作用。
53.1%的患者报告体重增加。11%的患者出现食欲下降，在年龄较小的病例中更常见（P = 0.006）。分别有16.3%、2.4%、1.4%和1%的患者报告腹痛、恶心/呕吐、腹泻和便秘。分别有5.7%、1.4%、1%、1%、1%和0.5%的患者出现头痛、震颤、头晕、色觉异常、肌阵挛和磨牙症。分别有8.1%、6.7%和0.5%的患者报告遗尿、脱发和皮疹。分别有1%、1%和0.5%的患者出现血小板减少、肝功能检查异常和白细胞减少。
低剂量丙戊酸盐单药治疗可能会引起许多副作用，大多数不会危及生命，无需采取措施。除了更多报告的并发症外，我们还观察到食欲下降（在较年轻患者中）、遗尿和色觉异常，这些在文献中只是简要讨论过，需要更多关注。
