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Introduction: Elevated plasma Homocysteine concentration is associatedwith increased risk for vaso-occlusive disease like cerebrovascularstroke, coronary artery disease, and also the risk of resistance to anti-epileptics and refractory epilepsy. Hyperhomocysteinemiahas been frequently associated with the administrationof Anti epileptic drugs (AED). This study aims at evaluating the effect of anti-epileptic therapy on serum Homocysteine levelsin children. Methods: 53 children (Males – 32, Females – 21)with Seizures in age group of 6 months–14 years, were recruitedfrom the Pediatric Outpatient and Inpatient department of a tertiary Hospital were included in the study. Serum Homocysteine (Hcy)levels of Children already on AEDs for >6months (Group A) were compared with Children before Initiation of Anti epileptic drugs (Group B).These children were followedup after 6 months of Anti epileptic therapy and Serum Homocysteinewas compared (Group C). Results: Average Hcy levelsin subjects who had already received >6 months of antiepileptic drug therapy were 12.58±2.68 μmol/l, compared to 8.83±2.82μmol/l, at recruitment (p=0.001). Significant increased levels werealso observed in children followed up after 6 months of AED –10.27±3.06 (μmol/l) compared to 8.63±2.90 (μmol/l) at initiationof AED. 9 children who received >1 AED had significantly higherlevels – 14.15±2.56 (μmol/l) compared to children on monotherapy– 10.22±3.06 (μmol/l). Carbamazepine therapy for 6 months caused significant increase in Hcy 10.78±2.82 (μmol/l) compared to baseline of 9.30±2.70 (μmol/l) (p=0.016). Conclusions: AEDsin children, particularly in those receiving multidrug or long duration treatment, cause hyperhomocysteinemia. This holds immense significance in malnourished populations.

Hyperhomocysteinemia;Anti epileptic therapy