Bone mineral density in children, adolescents, and young adults with epilepsy.
OBJECTIVE
The aim of this study was to assess bone mineral density (BMD) in a large population of children, adolescents, and young adults with epilepsy alone or in association with cerebral palsy and/or mental retardation.


METHODS
Ninety-six patients were enrolled in the study. The group comprised 50 males and 46 females, aged between 3 and 25 years (mean age 11 years). The control group consisted of 63 healthy children and adolescents (23 males, 40 females), aged between 3 and 25 years (mean age 12.1 years). Patients underwent a dual-energy x-ray absorptiometry (DEXA) scan of the lumbar spine (L1-L4) and the z scores were calculated for each patient; the t score was considered for patients 18 years of age or older.


RESULTS
Abnormal BMD was found in 56 patients (58.3%), with values documenting osteopenia in 42 (75%) and osteoporosis in 14 (25%). A significant difference emerged between epileptic patients and the control group in BMD, z score, and body mass index (BMI) (p = <0.001). Lack of autonomous gait, severe mental retardation, long duration of antiepileptic treatment, topiramate adjunctive therapy, and less physical activity significantly correlated with abnormal BMD.


CONCLUSIONS
This study detected abnormal BMD in more than half of a large pediatric population with epilepsy with or without cerebral palsy and/or mental retardation. The clinical significance of these findings has yet to be clarified.
Coppola
Giangennaro
G
Clinic of Child Neuropsychiatry, Second University of Naples, Italy. giangennaro.coppola@unina2.it
Fortunato
Delia
D
Auricchio
Gianfranca
G
Mainolfi
Ciro
C
Operto
Francesca Felicia
FF
Signoriello
Giuseppe
G
Pascotto
Antonio
A
Salvatore
Marco
M
D015502:Absorptiometry, Photon / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D015992:Body Mass Index; D015519:Bone Density; D002547:Cerebral Palsy / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D004827:Epilepsy / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging; D008297:Male; D009043:Motor Activity; D010024:Osteoporosis / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000453:epidemiology; D012307:Risk Factors; D055815:Young Adult
D000927:Anticonvulsants