title: Pathological fractures in epilepsy.
abstract: Fracture rates in epilepsy are two to three times that for the general population, although the influence of gender and age is not well defined. We examined, over a 7-year period at a single health care center, 750 patients with epilepsy who sustained the fractures. Among these patients, 293 (39%) had pathological fractures and 457 (61%) had traumatic/seizure-related fractures. Pathological fractures accounted for 71% of the 146 patients >60 years, a group traditionally at risk for pathological fractures (P<0.02). Fractures in epilepsy are distributed with bimodal peaks in the fifth and eighth decades of life, although pathological fractures are a significant contributor across the life span, accounting for 20 to 40% of patients traditionally thought not to be at risk for involutional osteoporotic fractures. Together these findings suggest that epilepsy, and/or its treatment, is a dominant influence in the pathogenesis of fractures and may exacerbate the effects of aging-related involutional osteoporosis.
authors.affiliation: Department of Neurology, University of Wisconsin-Madison, Madison, WI 53792-5132, USA. sheth@neurology.wisc.edu
authors.forename: Raj D
authors.initials: RD
authors.lastname: Sheth
authors.forename: Barry E
authors.initials: BE
authors.lastname: Gidal
authors.forename: Bruce P
authors.initials: BP
authors.lastname: Hermann
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000009:adverse effects*; D001851:Bone Diseases, Metabolic / Q000139:chemically induced / Q000150:complications*; D002648:Child; D004827:Epilepsy / Q000150:complications* / Q000188:drug therapy; D005260:Female; D050723:Fractures, Bone / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012640:Seizures / Q000150:complications*; D017678:Sex Distribution; D012737:Sex Factors
chemical_list: D000927:Anticonvulsants