Background: Epilepsy is a common neurological disorder, characterized by a disturbance in the electrical activity of the brain due to different factors. It includes many types of seizures with variable severity, seizure semiology, etiology, consequences, and management. The aim was to investigate the effects of traditional antiepileptic drugs (AEDs) versus newer AEDs on the thyroid hormone profile of children with epilepsy. Methods: This cross sectional study was conducted at Pediatrics Neurology Unit, Pediatric Outpatient Clinic and Clinical Pathology Department at Zagazig University Hospitals on children with epilepsy attending Pediatric Inpatient and Outpatient Clinic. They were classified into: Group I represents patients receiving traditional antiepileptic drugs (AEDs), Group II comprises patients receiving new AEDs, and Group III serves as the healthy control group. Every patient and the healthy group underwent thorough history taking, a comprehensive clinical examination, and laboratory investigations Results: There is statistically significant difference between the studied groups regarding free T3, free T4 and TSH. On doing pairwise comparison, difference is significant between control group and each other group.

While there is statistically significant difference between the studied groups regarding free T4, TSH and thyroid abnormalities (with significant difference between traditional AEDs and each other group), there is statistically non-significant difference between the studied groups regarding low free T3. Conclusion: Our findings suggest that traditional AEDs have significant effects on the thyroid hormone profile of epileptic children on long-term therapy and these effects were accompanied by higher subclinical and primary hypothyroidism compared to newer AEDs and control group.