الفهرس 
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Abstract
Epilepsy is a chronic disease of the brain affecting 3.5–5/1000 children in the developed countries with 41–187/100,000 new cases every year.
An epileptic seizure is defined conceptually as: “a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain.
Antiepileptics represent one of the largest and most diverse therapeutic medication classes.
Homocysteine is a sulfhydryl-containing amino acid derived from the essential amino acid methionine, which is abundant in animal sources of protein. Hyperhomocysteinemia is defined as a medical condition characterized by an abnormally high level (above 15 μmol/L) of homocysteine in the blood.
In children with epilepsy with long-term use of antiepileptic therapy, it is likely that vascular damage can be caused by metabolic, inflammatory, hormonal, and other effects on the vascular system.
Aim of the study is to evaluate the effect of antiepileptics drugs and its types in pediatric on serum level of Homocysteine, lipid profile and its association with increase of CIMT and carotid stiffness.
This study conducted on 60 epileptic children who had regular follow up in The Pediatric neurology Outpatient Clinic, Minia University Children and Maternity Hospital, during the period from January 2018 to march 2019; in addition to 25 apparently healthy children matching age & sex with diseased group were included as a control group,
This study included 4 groups:
group A :
They were 20 epileptic children, received single old antiepileptic drug for at least 1 year.
group B:
They were 20 epileptic children, received single new antiepileptic drug for at least 1 year.
group C :
They were 20 epileptic children, received 2 or more antiepileptic drug whatever its generation for at least 1 year.
group D :
Included 25 apparently healthy child matching age & sex with patient groups.
The studied groups were subjected to:
Full history taking
Thorough clinical examination
laboratory investigations including (homocysteine, lipid profile and renal function)
Radiological assessment to CIMT and carotid stiffness.
Our study revealed statically significant increase serum level of homocysteine, lipid profile (except HDL), and CIMT in children on monotherapy of old generation AEDs and polytherapy AEDs than that in children on monotherapy of new generation AEDs and control.
Also we found that serum level of homocysteine has significant positive correlation with lipid parameters TG, LDL and TC) but HDL has significant negative correlation with serum level of homocysteine and there was positive but not significant correlation with CIMT and carotid stiffness.
In conclusion:
from the results of our current study we concluded that:
1) The old generation antiepileptic drugs and polytherapy antiepileptic drugs modalities increase the serum level of homocysteine in children.
2) The new generation antiepileptic drugs have minimal effect on their serum level.
3) Children who use the old generation antiepileptic drugs and polytherapy antiepileptic drugs have increasing in carotid intima media thickness than those who use the new generation antiepileptic.
4) The increase in intima-media thickness is not necessarily associated with stiffer arteries.