Background: Epilepsy affects approximately 50 million individuals globally, and long-term antiepileptic drug (AED) therapy, while essential for seizure control, may adversely influence lipid metabolism and vascular integrity. Evidence regarding subclinical atherosclerotic changes among pediatric patients on chronic AED therapy remains limited, particularly in the Egyptian population. Objective: To assess the association between extended AED use and early atherosclerotic changes determined by carotid intima–media thickness (CIMT), and to compare the vascular and metabolic effects of different AED classes in children with epilepsy. Methods: This case–control study included 120 children (60 epileptic cases and 60 age- and sex-matched controls). Clinical evaluation, GASE scoring, fasting lipid profile, and bilateral carotid ultrasound for CIMT were performed. Results: Children on AED therapy had significantly elevated TC, TG, LDL-C, and LDL/HDL ratios, and lower HDL-C (p ≤ 0.001). CIMT was significantly increased bilaterally (p ≤ 0.001). Sodium valproate and carbamazepine caused the most significant metabolic and vascular changes, while levetiracetam showed minimal effects. Conclusions: Extended application of traditional AEDs is linked with dyslipidemia and increased CIMT, indicating early atherosclerosis. Levetiracetam demonstrated a safer metabolic profile. Cardiovascular monitoring is recommended in the management of pediatric epilepsy.
Keywords: Epilepsy; AEDs; Atherosclerosis; CIMT; Lipid profile; Children; Levetiracetam; Sodium valproate; Carbamazepine; Cardiovascular risk
How to cite this article:El Hadad AF, Hassan MM, Mansour TMM, Mohamed KR, Ahmed HAEA, Aladawy MA, Ezz-Elarab MN, Abdullah AM, Atherosclerotic Changes Associated with Long-Term Use of Antiepileptic Drugs in Epileptic Children: A Case-Control Study.Int J Drug Deliv Technol. 2026;16(1s): 893-701; DOI: 10.25258/ijddt.16. 893-701