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DOI: 10.1055/s-0045-1813051
Intima-Media Thickness of Carotid Artery as a Measure of Hyperlipidemia and Vascular Risk Factors on Prolonged Exposure to Antiepileptic Drugs
Authors
Background: Prolonged AED therapy is often associated with a wide range of chronic adverse effects, including metabolic and endocrine disturbances.
Aim This article aimed to measure intima-media thickness of the carotid artery as a measure of hyperlipidemia and as a surrogate marker for atherosclerosis and vascular risk factors in patients with epilepsy on chronic exposure to enzyme-inducing antiepileptic drugs like phenytoin, carbamazepine, and valproic acid.
Materials and Methods: A total of 104 consecutive patients who are on prolonged (>12 months) antiepileptic drugs, like phenytoin, carbamazepine, and valproic acid, who attended the epilepsy clinic in Nizam’s Institute of Medical Sciences, were included in the study. Detailed clinical examination, including demographic data, body mass index, electroencephalogram, and magnetic resonance imaging of the brain, following epilepsy protocol, serum fasting lipid profile, intima-media thickness of carotid artery, hsCRP, fasting insulin, c-peptide, lipoprotein A levels, and serum homocysteine levels, was done in all patients. All the subjects were divided into two groups: group 1, on ≤1 year of treatment with AED, and group 2, on chronic (>12 months) AED.
Results: The mean CA IMT (average) is significantly increased in group 2 compared with that in group 1 (0.590 + 0.163 vs. 0.478 + 0.072, p = 0.000). The increase is significant with phenytoin monotherapy compared with the other two drugs. The median CA IMT (average) increased with increased duration of treatment with carbamazepine and phenytoin but not with valproic acid. Adult epileptics showed a significant increase in the CA IMT, but not the children with epilepsy.
Conclusion: There is a significant increase in the mean carotid artery intima media thickness with more than 1 year of monotherapy with antiepileptic drugs like phenytoin, carbamazepine, and valproic acid. The increase is significant with phenytoin monotherapy compared with the other two drugs. The adult epileptics showed a significant increase in the CA IMT, but not the children with epilepsy.
No conflict of interest has been declared by the author(s).
Publication History
Article published online:
24 October 2025
© 2025. Indian Epilepsy Society. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)
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