Vestibular manifestations are frequent in patients with epilepsy. This may be a result of the permanent damaging effect of chronic epilepsy on the vestibular cortical areas and/or a toxic effect from prolonged carbamazepine therapy on the peripheral and central vestibular systems.

Background: Epilepsy is a chronic medical disease and is associated with comorbid adverse somatic conditions due to epilepsy itself or its long-term treatment. Objectives: This study evaluated cochlear function in patients with idiopathic epilepsy and treated with carbamazepine (CBZ). Patients and Methods: Included were 47 patients (mean age = 34.56 ± 7.11 years and duration of illness = 17.84 ± 7.21 years) and 40 healthy subjects. They underwent pure-tone audiometry and transient evoked otoacoustic emission (TEOAE) analyses. Results: Hearing loss (mainly bilateral mild) was reported in one third of patients. Compared to controls, patients had lower TEOAE amplitudes at 1.0–4.0 kHz particularly at high frequencies (3 and 4 kHz). Significant correlations were identified between TEOAE amplitudes with CBZ dose (at 3 kHz: r = –0.554, p = 0.008; at 4 kHz: r = –0.347, p = 0.01), its serum level (at 4 kHz: r = –0.280, p = 0.045) and duration of treatment (at 3 kHz: r = –0.392, p = 0.008; at 4 kHz: r = –0.542, p = 0.001). Conclusions: Long-term CBZ treatment may result in cochlear dysfunction and auditory deficits.