ABSTRACT
BACKGROUND: Epilepsy is a chronic medical disease and is associated with comorbid adverse somatic conditions due to epilepsy itself or its long-term treatment. OBJECTIVES: This study evaluated cochlear function in patients with idiopathic epilepsy and treated with carbamazepine (CBZ). PATIENTS AND METHODS: Included were 47 patients (mean age = 34.56 ± 7.11 years and duration of illness = 17.84 ± 7.21 years) and 40 healthy subjects. They underwent pure-tone audiometry and transient evoked otoacoustic emission (TEOAE) analyses. RESULTS: Hearing loss (mainly bilateral mild) was reported in one third of patients. Compared to controls, patients had lower TEOAE amplitudes at 1.0-4.0 kHz particularly at high frequencies (3 and 4 kHz). Significant correlations were identified between TEOAE amplitudes with CBZ dose (at 3 kHz: r = -0.554, p = 0.008; at 4 kHz: r = -0.347, p = 0.01), its serum level (at 4 kHz: r = -0.280, p = 0.045) and duration of treatment (at 3 kHz: r = -0.392, p = 0.008; at 4 kHz: r = -0.542, p = 0.001). CONCLUSIONS: Long-term CBZ treatment may result in cochlear dysfunction and auditory deficits.
Subject(s)
Anticonvulsants/adverse effects , Carbamazepine/adverse effects , Cochlea/physiopathology , Epilepsy/physiopathology , Labyrinth Diseases/chemically induced , Adult , Anticonvulsants/pharmacology , Anticonvulsants/therapeutic use , Audiometry, Pure-Tone , Auditory Threshold/drug effects , Auditory Threshold/physiology , Carbamazepine/pharmacology , Carbamazepine/therapeutic use , Cochlea/drug effects , Epilepsy/drug therapy , Female , Humans , Labyrinth Diseases/physiopathology , Male , Otoacoustic Emissions, Spontaneous/drug effects , Otoacoustic Emissions, Spontaneous/physiologyABSTRACT
OBJECTIVE: This study aimed to evaluate vestibular function in adults with chronic epilepsy of unknown etiology in the inter-ictal period. BACKGROUND: Epilepsy is a chronic medical disorder. Life-long therapy may be required in one-third of patients. Epilepsy is associated with comorbid somatic conditions which impairs patients' quality of life. METHODS: This cross-sectional study included 28 with generalized tonic clonic (GTC) convulsions and 14 and 3 with temporal (TLE) and frontal lobe (FLE) epilepsies with secondary generalization (all were on regular carbamazepine therapy) and 40 healthy control subjects. The patients' mean age was 34.97â±â7.35 years and the duration of illness was 18.75â±â7.99 years. All underwent videonystagmography (VNG). RESULTS: Compared with controls, patients had frequent vestibular symptoms including dizziness (62.22%) (pâ=â0.0001) and sense of imbalance (44.44%) (pâ=â0.0001). Eleven patients (24.44%) had central vestibular dysfunction (pâ=â0.0001); 9 (20%) had mixed vestibular dysfunction and one (2.22%) had peripheral vestibular dysfunction (pâ=â0.0001). Abnormalities were observed in saccadic (44.4%) and pursuit (42.2%) eye movements, optokinetic nystagmus (42.2%) and positioning/positional (11.11%) and caloric (13.33%) testing. TLE and FLE were associated with more VNG abnormalities than GTC. No significant differences were observed in the demographic and clinical characteristics between patients with and without VNG abnormalities. CONCLUSION: Vestibular manifestations are frequent in patients with epilepsy. This may be a result of the permanent damaging effect of chronic epilepsy on the vestibular cortical areas and/or a toxic effect from prolonged carbamazepine therapy on the peripheral and central vestibular systems.