Gülten Öztürk, Nezafet Öztürk Akar, Nahide Haykır, Olcay Ünver, Ayca Ciprut, Dilşad Türkdoğan
Southern Clinics of Istanbul Eurasia - 2025;36(4):331-339
Objective: This study aimed to assess the effects of commonly used anti-seizure medications (ASMs)-valproate (VPA), carbamazepine (CBZ), and levetiracetam (LEV)-on hearing function in school-aged children with newly diagnosed epilepsy. Methods: A prospective study was conducted on 16 treatment-naive children (mean age 11.5+/-3.7 years) diagnosed with idiopathic generalized or self-limited focal epilepsy per 2017 ILAE criteria. Patients received VPA (n=12), CBZ (n=2), or LEV (n=2), titrated to therapeutic levels within one month. Audiological assessments-including pure-tone audiometry (0.25-8 kHz), tympanometry with acoustic reflexes, distortion-product otoacoustic emissions (DPOAE), and auditory brainstem response (ABR)-were performed before treatment and after a mean follow-up of 10 months. Paired t-tests compared baseline and follow-up results (significance set at p<0.05). Results: All baseline hearing thresholds were <=25 dB HL. Post-treatment thresholds were unchanged except for a slight increase at 4 kHz in the right ear (+3.8 dB HL, p=0.009). ABR latencies and inter-peak intervals remained stable. Tympanometry and acoustic reflexes were unchanged. DPOAE amplitudes declined at 2 kHz (-7.3 dB, p=0.001) and 6 kHz (-4.7 dB, p=0.006) in the right ear, while left-ear measures remained stable. No auditory symptoms or adverse events were reported. Conclusion: Monotherapy with VPA, CBZ, or LEV over ~10 months did not result in clinically significant hearing impairment in children. However, minor frequency-specific reductions in cochlear emissions were noted. Further large-scale, drug-specific studies are needed to validate these preliminary findings.
