Capillary microscopy and hemorheology in children during antiepileptic monotherapy with carbamazepine and valproate

Capillary microscopy is a noninvasive technique for measuring red blood cell velocity and for determining nutritional blood flow in the capillaries of the skin. It can easily be performed in children. The aim of this study was to look for possible effects of an antiepileptic monotherapy with carbamazepine (CBZ) or valproate (VPA) on the peripheral microcirculation in epileptic children. We were able to examine 14 children with CBZ and 24 children with VPA, recruited of our Neuropediatric Unit. The results were compared to normative values, determined in former analysis in 207 healthy children. We found significant differences for both antiepileptic drugs in capillary density, tortuous index of the capillaries, capillary diameter and flow rate of erythrocytes. Additionally, there were changes in plasma viscosity and the aggregation of erythrocytes. These microcapillary effects could by of special interest in the relationship of a long term antiepileptic therapy and the development of vascular diseases. We suggest that the influence of AEDs on microcirculation should also be considered in further studies on cardiovascular changes in patients with antiepileptic long-term medication.