Effects of valproic acid and levetiracetam monotherapy on balance functions in patients with generalized epilepsy.

BACKGROUND: It is reported that antiepileptic drugs have an effect on balance functions. The aim of the study was to evaluate and compare the effects of valproic acid and levetiracetam monotherapy on balance functions in patients with generalized epilepsy using objective test methods. METHODS: The study included 43 generalized epilepsy patients aged 18-60 years, including 20 patients receiving valproic acid monotherapy, 23 patients receiving levetiracetam monotherapy, and 25 healthy individuals as controls, in the Neurology Clinic of a university hospital in eastern Turkey. The demographic data form was filled out and the Video Head Impulse Test and Vestibular Evoked Myogenic Potentials test were performed. RESULTS: Statistically significant differences were obtained between the groups in lateral, posterior, and anterior semicircular canal gains and RALP and LARP asymmetry values in the V-HIT test (p < 0.05). Statistically significant differences were obtained between the groups in P1, N1 latency and asymmetry values in the C-VEMP test and in N1, P1 latency, amplitude, and asymmetry values in the o-VEMP test (p < 0.05). CONCLUSION: Valproic acid and levetiracetam may affect the vestibulocular and vestibulocolic reflex pathways negatively. In this cohort, valproic acid had more pronounced adverse effects on balance functions as compared to levetiracetam.

Evaluation of vestibulo-ocular reflex with functional head impulse test in healthy individuals: normative values.

Objectives: This study aimed to determine the normative values of the functional head impulse test (fHIT) test in healthy young adults. Materials and methods: The study included 100 individuals, 58 females and 42 males, aged 20-25 years. Beon Solution Zero Branco (TV) fHIT test was applied to all participants. FHIT results were analyzed in terms of lateral-posterior-anterior semicircular canals (SSCs), gender, and right-left ear. Results: In the fHIT test, for the lateral SSC the mean percent correct answer (%CA) values for 4,000-6,000°/s2 and 1,000-7,000°/s2 were 88.52 ± 9.04 and 89.91 ± 6.95, respectively; for the posterior SSC, the mean %CA values for SSC 3000-6,000°/s2 and 1,000-7,000°/s2 were 90.63 ± 8.69 and 91.16 ± 7.42, respectively; for the anterior SSC, the mean %CA values for 3,000-6,000°/s2 and 1,000-7,000°/s2 were 91.21 ± 7.96 and 91.49 ± 7.13, respectively. There was no statistically significant difference between the right and left ear in %CA values at all accelerations in all SSCs (p > 0.05). There was a statistically significant difference between genders in the mean %CA values for 6,000-7,000°/s2, 4,000-6,000°/s2, and 1,000-7,000°/s2 in the lateral SSC and 3,000-6,000°/s2 in the anterior SSC (p < 0.05). Conclusion: The FHIT is a noninvasive test battery that functionally evaluates the VOR of the six semicircular canals. In clinical use, the determination of normative values at all accelerations (1,000-7,000 degrees/s2) constitutes an important database for future studies to distinguish pathologic results.