title: Can the adverse effects of antiepileptic drugs be detected in saccadic eye movements?
abstract: OBJECTIVE
  The objective of this study was to determine whether the adverse effects of antiepileptic-drugs could be assessed by the eye movements of epilepsy patients.
  
  
  METHODS
  This study was performed prospectively in a single tertiary hospital. The inclusion criteria for this study were as follows: (1) consecutive patients with epilepsy taking antiepileptic-drugs regularly for at least 1 year, (2) the absence of structural lesions on MRI, (3) an age ≥16 years old, (4) not using medications that could influence eye movement, and (5) a normal neurological examination. The latency, peak velocity and accuracy of the saccades and the gain of the pursuits were recorded by video-based electro-oculography. We analyzed the differences in the parameters of the eye movements for 75 patients with epilepsy and 20 normal controls matched for age and sex.
  
  
  RESULTS
  The total latency (1017.7 ± 148.9 ms vs. 1150.7 ± 106.6 ms, p=0.0003) and accuracy [370.7% (95% CI 364.1-376.4%, range 306-408.2%), 92.7% as total accuracy normalized value vs. 383.6% (95% CI 378.8-398%, range 322.9-417.4%), 95.9% as total accuracy normalized value, p=0.0005] were significantly different between the patients with epilepsy and normal controls. For the detection of nystagmus with video-based electro-oculography, the clear cutoff values of total accuracy (≤388.7%, 97.2% as total accuracy normalized value) revealed 93.4% sensitivity and 28.6% specificity, and the clear cutoff values of total latency (≤1005.5 ms) showed 49.2% sensitivity and 78.6% specificity.
  
  
  CONCLUSIONS
  The total latency and accuracy of video-based electro-oculography may be screened to identify patients with a high risk of adverse effects with antiepileptic-drugs.
authors: Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan 612-896, Republic of Korea.
authors: Kang Min
authors: KM
authors: Park
authors: Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan 612-896, Republic of Korea.
authors: Kyong Jin
authors: KJ
authors: Shin
authors: Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan 612-896, Republic of Korea.
authors: Sam Yeol
authors: SY
authors: Ha
authors: Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan 612-896, Republic of Korea.
authors: JinSe
authors: J
authors: Park
authors: Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan 612-896, Republic of Korea.
authors: Si Eun
authors: SE
authors: Kim
authors: Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan 612-896, Republic of Korea.
authors: Hyung Chan
authors: HC
authors: Kim
authors: Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan 612-896, Republic of Korea.
authors: Joon Won
authors: JW
authors: Lee
authors: Department of Neurology, Haeundae Paik Hospital, Inje University College of Medicine, Haeundae-ro 875, Haeundae-gu, Busan 612-896, Republic of Korea. Electronic address: epidoc@inje.ac.kr.
authors: Sung Eun
authors: SE
authors: Kim
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D004585:Electrooculography; D004827:Epilepsy / Q000188:drug therapy / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D009760:Nystagmus, Physiologic / Q000187:drug effects / Q000502:physiology; D011446:Prospective Studies; D012438:Saccades / Q000187:drug effects* / Q000502:physiology; D012680:Sensitivity and Specificity; D062606:Tertiary Care Centers; D014741:Video Recording
chemical_list: D000927:Anticonvulsants
keywords: Anticonvulsants; Epilepsy; Eye movements