Abstracts

Rationale: Epilepsy patients are often required to take anti-epileptic drugs (AEDs) for many years. Leucopoenia is one of common side effects and sometimes it annoying physicians especially AED is effective. We studied the course of chronic leucopoenia and the risk of chronic leucopoenia.Methods: We retrospectively evaluated patients with epilepsy who received AEDs and monitored white blood cell (WBC) counts at least twice a year for over 20 years. Patients with other disease that may cause leucopenia were excluded. We defined severe leucopenia is WBC < 3000/μl. We looked into the course of WBC count in patients who showed severe leucopenia more than once during this long monitoring. We also statistically analyzed the risk of chronic leucopenia and the number of AEDs using chi-square test.Results: Total 178 patients were included. The mean age was 49 years old, mean duration of following up was 27 years. The severe leucopenia was detected in 42 patients (24%) at least once. However, 25 out of 42 patients (60%) recovered to WBC≧3000 at the next blood test every time. 17 patients showed leucopoenia twice in a row at least once. There are 8 patients recovered from leucopenia without AED reductions after detected leucopenia repeatedly for 2 to 20 years (mean duration; 10.3 years). Four patients were required to reduce AEDs for leucopenia. There are 76 patients who were not changed their number of AEDs during our follow up. Eight of 33 (24%) patients with one AED during follow up and six of 25(24%) with two AEDs developed leucopenia at least once, while nine of 18 (50%) with more than three AEDs developed leucopoenia. (Table 1) Leucopoenia occurs significantly more frequently in patients with more than three AEDs in contrast to those patients with only one or two AEDs (p=0.0369)Conclusions: This study reveals leucopenia is observed very highly in epilepsy patients during long follow up. However in most of cases, AEDs reductions were unnecessary. Also there are patients who recovered naturally after repeated leucopenia for years. To keep more than 3 AEDs are the statistically higher risk of chronic leucopoenia though one or two AEDs may cause chronic leucopoenia. Acknowledgement: We would like to thank Mr. Nathanael Hevelone, Ms. Eriko Setoguchi and Ms. Kiyomi Fujimura for their great help.