Bone Health and Antiepileptic Drugs in Children with Epilepsy: A Pilot Study

Abstract

Epilepsy, a chronic neurological disorder necessitating prolonged antiepileptic medication, has been associated with deficiencies in vitamin D and related bone disorders in children. This study aims to investigate the prevalence of vitamin D deficiency, calcium deficiency, and bone diseases in children undergoing antiepileptic drug (AED) therapy. A retrospective study was conducted on 60 children (0-16 years old) with epilepsy at King Fahad Specialist Hospital-Dammam from 2016 to 2018. Participants were administered 800 IU/day of vitamin D for 6 months. Comprehensive assessments, including tests for calcium, phosphorus, 25-hydroxyvitamin D (25-OHD), 1,25-hydroxyvitamin D (1,25 OHD), parathyroid hormone (PTH), thyroid function [thyroid-stimulating hormone (TSH)], alkaline phosphatase (ALP), and bone density, were performed after 6 months of oral vitamin D supplementation. No significant associations were observed between age, sex, age of onset, duration of epilepsy, symptoms of vitamin D deficiency, dietary factors, and the levels of calcium, phosphorus, 25-OHD, 1,25-OHD, PTH, TSH, ALP, and bone scan. Carbamazepine (CBZ) was the only AED that affected bone metabolism in general (P = 0.024). Calcium was mostly found to be abnormal after using AED with vitamin D (800 IU/day) for 6 months (P = 0.05). 25-OHD deficiency was associated with use of CBZ in pediatric epilepsy. Considering its potential impact on bone metabolism, higher vitamin D doses may be advisable for children on long-term AED therapy to mitigate these abnormalities.