Serum carnitine levels in ambulatory epilepsy outpatients

Carnitine deficiency related to epilepsy or antagonism of carnitine by antiepileptic drugs (AEDs) has attracted increasing attention since the first recognition of a neuromuscular deficiency syndrome in 1973’. Carnitine deficiency is linked to the potentially fatal hepatotoxicity that occasionally attends valproate therapy, particularly in children2, and has been documented in adult and pediatric patients taking valproate and other anticonvulsants3-9. The role of such deficiency in the lethargy, sedation, and cognitive disturbance that often attends chronic AED treatment is not clear”. We measured serum total and free carnitine levels in an ambulatory population of epilepsy patients well-controlled on valproate monotherapy or valproate plus a second medication, and without apparent hepatic or neuromuscular adverse effects from drug treatment.