The effects of oxcarbazepine and valproate therapies on growth in children with epilepsy.
OBJECTIVE
This study aimed to evaluate the effects of monotherapy with valproate or oxcarbazepine on the linear growth of children with idiopathic epilepsy.


METHODS
Antiepileptic treatment with valproate or oxcarbazepine was initiated in 76 patients. These were evaluated at baseline and at 6 and 18 months after commencement of therapy to determine height standard deviations (height z-scores). Serum ghrelin, insulin-like growth factor-1, and insulin-like growth factor-binding protein-3 levels were measured.


RESULTS
In prepubertal patients receiving oxcarbazepine, height z-scores were elevated after 6 and 18 months of therapy (p = 0.008 and p = 0.001, respectively); in pubertal patients, a significant increase was noted at the 18th month of therapy (p = 0.004). In prepubertal patients receiving oxcarbazepine, serum standardized insulin-like growth factor-1 and insulin-like growth factor-binding protein-3 levels were significantly higher at the 18th month of therapy compared with baseline (p = 0.005 and p = 0.004, respectively). In puber-tal patients receiving valproate, serum ghrelin levels were significantly decreased at the 18th month of therapy compared with baseline (p = 0.006).


CONCLUSIONS
Exposure to oxcarbazepine stimulated linear growth in epileptic patients through mechanisms involving the release of insulin-like growth factor-1 and insulin-like growth factor-binding protein-3. In contrast, expo-sure to valproate did not affect linear growth, but did lead to a decrease in serum ghrelin levels.
Department of Pediatric Neurology, Karadeniz Technical University, Trabzon, Turkey.
Ali
A
Cansu
Ediz
E
Yesilkaya
Ayse
A
Serdaroglu
Orhun
O
Camurdan
Tugba Luleci
TL
Hirfanoglu
Abdulbaki
A
Karaoglu
Aysun
A
Bideci
Peyami
P
Cinaz
D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use*; D001827:Body Height / Q000187:drug effects*; D002220:Carbamazepine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D054439:Ghrelin / Q000097:blood; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008297:Male; D000078330:Oxcarbazepine; D011627:Puberty / Q000097:blood / Q000187:drug effects*; D014635:Valproic Acid / Q000627:therapeutic use*
D000927:Anticonvulsants; D054439:Ghrelin; C515497:IGFBP3 protein, human; D018972:Insulin-Like Growth Factor Binding Protein 3; D002220:Carbamazepine; D014635:Valproic Acid; D007334:Insulin-Like Growth Factor I; D000078330:Oxcarbazepine