REDUCTION IN INTERNAL CAROTID ARTERIAL BLOOD-FLOW VELOCITY IN CHILDREN DURING ANTIEPILEPTIC DRUG-THERAPY WITH CLINICAL DOSAGES

We studied the effect of antiepileptic drugs (AEDs) on internal caroti d artery (ICA) blood flow velocity, as an index of total cerebral bloo d flow (CBF). The subjects were 45 newly diagnosed children with febri le convulsion or epilepsy who were seizure-free for a period long enou gh not to affect the results. They had no neurologic deficit, received fixed monotherapy, and were examined by a noninvasive Doppler ultraso und method, in comparison with 13 age-matched normal volunteers with n o AED. In 30 patients, the measurements were per formed before and aft er AED administration [10 with phenobarbital (PB), 10 with carbamazepi ne (CBZ), and 10 with valproate (VPA)], and performed before and after AED discontinuation in the remaining 15 patients (all with PB). Norma l volunteers underwent the two consecutive examinations with a mean in terval equal to that of the entire patient group, and there was no dif ference in velocity values between the measurements. In patients recei ving CBZ or VPA, a significant reduction was noted in blood flow veloc ity after drug administration. Although velocity values in the patient s receiving PB did not change after drug administration, they were sig nificantly increased after complete discontinuation. In the present st udy, a slight but significant reduction in CBF caused by AED administr ation at therapeutic doses in children was suggested.