Comparative study of sodium valproate monotherapy versus antiepileptic polytherapy on thyroid profile and serum magnesium levels in children with epilepsy
DOI:
https://doi.org/10.18203/2349-3291.ijcp20263306Keywords:
Antiepileptic drugs, Epilepsy in children, Hypomagnesemia, Sodium valproate, Subclinical hypothyroidism, Thyroid functionAbstract
Background: Prolonged antiepileptic drug (AED) therapy may alter thyroid homeostasis and serum magnesium levels, both of which are critical for neurodevelopment and growth in children.
Methods: This cross-sectional study enrolled 168 children aged 3–15 years with epilepsy on AED therapy for ≥6 months. Participants were categorised as group A (sodium valproate monotherapy, n=119), group A1 (other monotherapy, n=25), group B1 (polytherapy including valproate, n=17), and group B2 (polytherapy excluding valproate, n=7). Serum free triiodothyronine (FT3), free thyroxine (FT4), thyroid-stimulating hormone (TSH), and magnesium were measured using standard methods. The chi-square test and student's t-test were applied; p<0.05 was considered significant.
Results: Subclinical hypothyroidism (SCH) was identified in 10 children (5.9%), with the highest prevalence in group B1 (11.8%); the inter-group difference was not statistically significant (p=0.767). Mean FT4 was 1.30±0.25 ng/dL and mean FT3 was 3.20±0.54 pg/ml. Hypomagnesemia was present in 14 children (8.3%), with a statistically significant duration-dependent increase from 3.7% at <1 year to 20.9% at >2 years (p=0.005). No significant inter-group difference in hypomagnesemia was observed (p=0.924).
Conclusions: Polytherapy was associated with a numerically higher, but statistically non-significant, rate of SCH. Hypomagnesemia showed a significant cumulative, duration-dependent increase regardless of drug regimen. Routine monitoring of thyroid function and serum magnesium is recommended for all children on long-term AED therapy, particularly those on polytherapy or treated for more than two years.
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