Auditory Evaluation of Three Most Commonly Used Anti-Seizure Medications VPA, CBZ and LEV in School-Aged Children: A Single Center Prospective Study with Extensive Auditory Test Design in a Small Epileptic Cohor

OpenAlex İngilizce

Objective: This study aimed to assess the effects of commonly used anti-seizure medications (ASMs)-valproate (VPA), carbamazepine (CBZ), and levetiracetam (LEV)-on hearing function in school-aged children with newly diagnosed epilepsy.Methods: A prospective study was conducted on 16 treatment-naive children (mean age 11.5±3.7 years) diagnosed with idiopathic generalized or self-limited focal epilepsy per 2017 ILAE criteria.Patients received VPA (n=12), CBZ (n=2), or LEV (n=2), titrated to therapeutic levels within one month.Audiological assessments-including pure-tone audiometry (0.25-8 kHz), tympanometry with acoustic reflexes, distortion-product otoacoustic emissions (DPOAE), and auditory brainstem response (ABR)-were performed before treatment and after a mean follow-up of 10 months.Paired t-tests compared baseline and followup results (significance set at p<0.05).Results: All baseline hearing thresholds were ≤25 dB HL.Post-treatment thresholds were unchanged except for a slight increase at 4 kHz in the right ear (+3.8 dB HL, p=0.009).ABR latencies and inter-peak intervals remained stable.Tympanometry and acoustic reflexes were unchanged.DPOAE amplitudes declined at 2 kHz (-7.3 dB, p=0.001) and 6 kHz (-4.7 dB, p=0.006) in the right ear, while left-ear measures remained stable.No auditory symptoms or adverse events were reported.Conclusion: Monotherapy with VPA, CBZ, or LEV over ~10 months did not result in clinically significant hearing impairment in children.However, minor frequency-specific reductions in cochlear emissions were noted.Further large-scale, drug-specific studies are needed to validate these preliminary findings.