Abstract
Background
This study compared the effects of anti-seizure medication (ASM) monotherapy and polytherapy on hematological parameters in patients with epilepsy (PWE).
Objective
To compare hematological parameters and derived inflammatory indices in patients with epilepsy receiving ASM monotherapy versus polytherapy and determine independent predictors and discriminatory performance of these parameters.
Methods
A hospital-based cross-sectional study was conducted between January and June 2024 at the Neurology Clinic of Olabisi Onabanjo University Teaching Hospital, Sagamu, Nigeria. Two hundred adult PWE were enrolled and classified into monotherapy or polytherapy groups. Sociodemographic and clinical data were collected. Venous blood samples were analyzed using the Sysmex XN-1000 hematology analyzer. Statistical analyses included independent t-tests, chi-square tests, logistic regression, and receiver operating characteristic (ROC) analysis (p < 0.05).
Results
Males predominated in the monotherapy group (58.8%), while females predominated in the polytherapy group (84.1%; p < 0.001). Monotherapy showed significantly higher neutrophils, hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin concentration, and neutrophil–lymphocyte ratio, but lower mean platelet volume. Neutrophils, hemoglobin, MCV, MCHC, and MPV independently predicted treatment pattern. ROC analysis showed moderate discrimination for MPV, while others performed poorly.
Conclusion
ASM polytherapy is associated with greater hematological alterations. Monotherapy should be prioritized when feasible, with routine hematological monitoring recommended.
Keywords
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