Bone mineral density and vitamin D status in children with epilepsy, cerebral palsy, and cerebral palsy with epilepsy

Tosun, Ayşe; Karaca, Seda Erişen; Ünüvar, Tolga; Yürekli, Yakup; Yenisey, Çiğdem; Ömürlü, İmran Kurt

doi:10.1007/s00381-016-3258-0

Cited by 31 publications

(20 citation statements)

References 25 publications

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“…The same study indicated that the duration of treatment and the number of AEDs subscribed (monotherapy or polytherapy) were correlated with abnormal BMD to a greater extent. Moreover, other studies have indicated that polytherapy treatment for epilepsy in children is related to decreased BMD levels [8][9][10]. In parallel, a study by Yaghini et al indicated that both cytochrome p450 inducing and non-inducing AEDs had caused a reduction of BMD although epileptic children without treatment had no decrease in BMD.…”

Section: Aeds and Vitamin Dsupporting

confidence: 51%

“…Authors suggested that the direct influence of anticonvulsants to osteoblasts and osteoclasts may be one of the major mechanisms which lead to ERBD [7]. However, other studies have proposed that epilepsy is associated with increased bone turnover [4,8,10,11,17,20]. Although the major indication for this association is the elevated ALP levels, this can be also attributed to increased bone absorption as ALP is not a specific biomarker for bone turnover [6].…”

Section: Aeds and Bone Cells And Bone Turnovermentioning

confidence: 95%

“…Tosun et al suggested that phenytoin, carvamazepine and valproate acid are suspicious for altering the synthesis and metabolism of sex steroids which are essential for bone development and maintenance of adequate bone mass [10]. Additionally, phenytoin and phenobarbitale can cause vitamin K deficiency as vitamin K acts as a cofactor for the production of osteocalcin, matrix GI protein and protein S from osteoblasts, which are essential proteins for the bone production.…”

Section: Aeds and Bmdmentioning

confidence: 99%

“…Reduced 24,25-(OH) 2 D levels may be a major step in the mechanism of epilepsy related osteomalacia and osteopenia [27]. Polytherapy for the treatment of epilepsy is combined with reduced vitamin D levels [10]. Topiramate can cause osteomalacia, renal calculi and osteoporosis through increased bone turnover and the hypocalcaemia.…”

Section: Aeds and Vitamin Dmentioning

confidence: 99%

“…Absence of daily calcium requirements can lead to decreased BMD. Daily calcium intake during childhood must be about 700 mg between 1-3 years, 1000 mg between 4-8 years, 1300 mg between 9-18 years of age [10].…”

Section: Nutrition and Exercisementioning

confidence: 99%

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Metabolic bone disorders in children with epilepsy

Manolis¹,

Lepetsos²,

Tzefronis³

et al. 2017

Rheumatol Orthop Med

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Epilepsy during childhood is the most usual neurological disease and it is characterized by recurrent seizures influencing the everyday life of children. As a treatment, antiepileptic drugs (AEDs) affect the bone metabolism resulting in osteoporosis, osteomalacia, rickets, abnormal dentition and increased rate of fractures. Reduced bone mass density (BMD) has been found in the majority of children with epilepsy and a large proportion of these patients has osteoporosis. Furthermore, in many studies the BMD in the epileptic children is significantly lower than in the healthy one. Overall nutritional status affects the manifestation of seizures and the physiology of bone tissue. Especially the levels of vitamin D and calcium play a vital role in the expression of epilepsy related bone disease (ERBD) in children.In parallel, epileptic children should be adequately mobilized as less physical daily activity and inability to walk independently lead to decreased BMD levels which are the major cause of increased number of fractures. Close monitoring of BMD, nutritional status evaluation and prevention of ERBD is as crucial as treatment of epilepsy with antiepileptic drugs, in order to prevent the expression of fractures. Every specialty involved in the treatment of epileptic children must be aware of the consequences of epilepsy in bone tissue.

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Section: Aeds and Vitamin Dsupporting

confidence: 51%