Effect of vitamin D and calcium on bone mineral density in children with CP and epilepsy in full-time care.
Atraumatic fractures are often seen in children and adolescents with cerebral palsy (CP) and epilepsy in full-time care. Increased bone fragility was postulated to be due to osteopenia resulting from a combination of factors including immobilization and antiepileptic treatment. The aim of this study was to determine the effect of vitamin D and calcium substitution on bone mineral density (BMD) in a group of children with CP in full-time care. Twenty children with the most severe form of CP (spastic quadriplegia) who had been treated with antiepileptic drugs for a relatively long period of time were included in the study. Physical examination and laboratory analyses excluded other possible causes of osteopenia. BMD was measured by dual X-ray absorptiometry. Thirteen patients were treated for 9 months with 1,25-dihydroxy-cholecalciferol vitamin D (0.25 mcg daily) and with calcium (500 mg daily). Seven control children were used for observation only. BMD greatly increased in the treated group, while children with CP in full-time care who did not receive vitamin D and calcium substitution continued to lose their bone mass. It can be concluded that the addition of vitamin D and calcium increases BMD in children with the most severe form of CP, who are receiving antiepileptic drugs.
Jekovec-Vrhovsek
M
M
Center Dolfke Bostjancic Draga, Ljubljani, Slovenia.
Kocijancic
A
A
Prezelj
J
J
D015502:Absorptiometry, Photon; D000293:Adolescent; D000299:Adolescent, Institutionalized; D000469:Alkaline Phosphatase / Q000097:blood; D000927:Anticonvulsants / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects*; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D002117:Calcitriol / Q000008:administration & dosage*; D002118:Calcium / Q000008:administration & dosage* / Q000097:blood; D002547:Cerebral Palsy / Q000097:blood / Q000150:complications*; D002648:Child; D002674:Child, Institutionalized; D004827:Epilepsy / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D010710:Phosphates / Q000097:blood; D016896:Treatment Outcome
D000927:Anticonvulsants; D010710:Phosphates; D000469:Alkaline Phosphatase; D002117:Calcitriol; D002118:Calcium