Bone mineral density in children with long-term antiepileptic therapy

Abstract

Introduction Vitamin D active metabolites deficit that is altered by negative calcium and phosphorus balance is a potential complication during long-term antiepileptic drug therapy. Objective The aim of this study was to examine lumbar bone mineral density (BMD) in epileptic children receiving antiepileptic drug therapy longer than one year. Methods The examined sample consisted of 34 epileptic children, 18 male and 16 female, aged 6-12 (9.77±2.01) years, treated with carbamazepine, valproate, phenobarbital, lamotrigine or their combination without vitamin D supplementation. The lumbar spine BMD (L 1 -L 4) was estimated by a Lunar densitometer and obtained results were compared with results of 35 matched population of healthy children from the control group. Results Lumbar BMD Z-score was significantly lower in female patients treated with antiepileptic therapy compared with those in the control group (-1.048±1.35 vs. -0.399±0.518; p=0.03). Bone mineral density Z-score decrease of both gender groups receiving antiepileptic polytherapy was significantly lower compared to the control group (-1.153±0.938 vs. -0.043±0.815; p=0.007). Therapy duration had no influence on the lumbar BMD level decrease either in boys (r xy =0.33; p=0.174) or in girls (r xy =0.02; p=0.935) treated with antiepileptic therapy. Conclusion Our results have indicated that antiepileptic drug therapy usage longer than one year can have adverse affects on the lumbar spine BMD (L 1 -L 4) in epileptic children, and that prophylactic vitamin D supplementation is also necessary in these patients.