الفهرس 
CHILDHOOD EPILEPSY CLASSIFICATIONOnly 14 pages are availabe for public view
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Abstract
Background: Epilepsy is as a chronic condition characterized by the recurrence of unprovoked seizures. The experience of evoked potentials in patients with epilepsy is sparse. Earlier studies in the literature, especially during the 1970s and 1980s, were conducted in previously treated epilepsy patients primarily to investigate drug effects or drug toxicity on afferent nerve conduction within the central nervous system.
Aim of the Work: So, here in this study we stressed on the effect of childhood epilepsy itself on the visual pathway.
Patients and Methods: This study enrolled 50 epileptic children drug naïve and 50 age and sex matched healthy controls, both groups were subjected to pattern reversed visual evoked potential and only 28 of the patients and 28 of the control group were subjected to ocular coherence tomography, starting from March 2021. The 50 patients were divided into 2 groups, the first one enrolled 23 patients that received levetiracetam and the 2nd one enrolled 27 patients that received valproate. Both groups were followed up over 24 months and follow up VEP and OCT done to compare the two groups and correlate with the baseline parameters.
Results: 66% of the patients’ group was boys while 34% were girls, with mean age 10.5± 3.47. By measuring VEP in the two groups the mean P100 latency in the right eye and the left one of the control group was 110.4±3.76ms and 111.25±3.92ms respectively while in the patients group was 114.94±12.81ms and 115.37±11.88ms respectively that showed significant difference between the two groups with p- value 0.020 and 0.023 respectively. By measuring the OCT between 28 patients of each group, the mean average RNFL thickness of the right eye in the control group was 115.86±12.78µm, while it was 106.43±8.14µm in the patients group which is of significant difference with p value 0.002.
Conclusion: There was prolonged latency in the epileptic children before starting AEDs more than the control group; also there was thinning of the retinal nerve fiber layer (RNFL) thickness and average part of the ganglion cell complex (GCC) thickness more in the epileptic children than in the healthy controls. This means that there was a disruption of the neural circuit by the epilepsy due to disruption of gabamenergic neurotransmitter system which plays an important role in mediating responses of cells in the visual cortex and retina and assists in shaping the receptive fields of the pyramidal cells in the superficial layers of the occipital cortex. That favors that epilepsy can be classified as a neuro-degenerative disorder. Meanwhile, the use of 2 AEDs here didn’t have any significant impact on the visual pathway except mild affection of VPA on inferior portion of RNFL thickness of the left eye that became thinner after one year of treatment, yet there was none –significant difference between the 2 medications.