Children with
epilepsy and identified as responders to antiseizure medications (ASMs) were found to present markedly higher
ghrelin plasma levels when compared to drug-resistant patients. However, it was undetermined if this phenotype could be influenced by the ASMs. Here, we prospectively investigated total
ghrelin and
des-acyl ghrelin (DAG) plasma levels by
enzyme-linked
immunosorbent assay before and after ASM administration. Inclusion criteria were: (i) subject with a suspicion of
epilepsy; (ii) age ranging from 0 to 16 years; and (iii) informed consent signed by parents or caregivers. Exclusion criteria were acute or chronic metabolic disorders with occasional convulsions but without
epilepsy. Fifty patients were followed over a period of one year in Italian neuropediatric centers. Apart from a few exceptions, the majority of children were responsive to ASMs. No differences were found in total
ghrelin and DAG levels before and after the treatment, but total
ghrelin levels were significantly lower in children with
generalized epilepsy compared to those with combined focal and
generalized epilepsy. Moreover, the
ghrelin-to-DAG ratio was also markedly lower in
generalized epilepsies compared to all the other types of
epilepsy. Finally,
ghrelin was unchanged by ASMs, including the first (e.g.,
carbamazepine), second (
levetiracetam), and third (
lacosamide) generation of
anticonvulsants.