Can the adverse effects of antiepileptic drugs be detected in saccadic eye movements?. (February 2015)

• Record Type: Journal Article
• Authors: Park, Kang Min; Shin, Kyong Jin; Ha, Sam Yeol; Park, JinSe; Kim, Si Eun; Kim, Hyung Chan; Lee, Joon Won; Kim, Sung Eun
• Is Part Of: Seizure. Volume 25(2015)
• Page Start: 33
• Page End: 36
• Publication Date: 2015-02
• Subjects: Epilepsy -- Eye movements -- Anticonvulsants; Epilepsy -- Periodicals; Epilepsy -- Periodicals; Seizures -- Periodicals; Épilepsie -- Périodiques; Electronic journals; Electronic journals; 616.853
• DOI: 10.1016/j.seizure.2014.12.003
• Languages: English
• ISSNs: 1059-1311

Abstract

Highlights: Investigate the adverse effects of antiepileptic drugs by the eye movements. Saccade latency and accuracy are different between epilepsy and normal subjects. The eye movements may be screened to detect adverse effects. Abstract: Purpose: 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.