Abstract
Objective: To determine the frequency of valproate induced thrombocytopenia in children with epilepsy.
Methodology: This cross-sectional study was conducted at department of pediatric neurology, The Children’s Hospital and Institute of Child Health, Multan from January 2023 to June 2023. Children of both genders, aged 5-12 years with epilepsy, using valproate monotherapy for at least last three months, were included. Demographical and clinical characteristics were noted. The blood samples were analyzed promptly using an autoanalyzer, taking platelet count<150,000/mm3 as thrombocytopenia.
Results: In a total of 167 children, there were 89 (53.3%) females. Mean age, duration of disease, valporate use duration, and valporate dose were 8.3±1.7 years, 30.6±8.4 months, 18.5±10.0 months, and 40.2±10.9 mg/kg/day, respectively. Median platelets count was 184,257/mm3 (interquartile range: 165,726-213,908 /mm3), ranging between 20,500/mm3 to 341,000/mm3. The thrombocytopenia was found in 35 (21.0%) children. The frequency of thrombocytopenia in 10-12-year-old children was significantly higher (42.9% vs. 15.9%, p=0.002). Frequency of thrombocytopenia was significantly associated with higher disease duration (p<0.001), higher duration (>12 months) of Sodium Valproate use (82.9% vs. 36.4%, p<0.001), and higher Valproate dose (71.1% vs. 24.2%, p<0.001).
Conclusion: The frequency of thrombocytopenia in epileptic children on valproate therapy was high. Longer epilepsy duration, and higher doses of valporate therapy were associated with thrombocytopenia.

Key words: Epilepsy, platelet count, seizure, thrombocytopenia, valproic acid.