title: Influences of bone and mineral metabolism in epilepsy.
abstract: BACKGROUND
  Patients with epilepsy are at increased risk for metabolic bone disease, low bone mineral density and fractures.
  
  
  METHODS
  This article reviews the predictors and mechanisms of bone loss in patients with epilepsy. It provides information regarding the basic bone biology, evidences of osteopathy with epilepsy and the potential mechanisms of its pathogenesis. This review shows that long-term use of antiepileptic drugs (AEDs) is associated with the risk of osteopathy. However, age, gender, low body mass, severity of epilepsy, co-morbid conditions, institutionalization and calcium and vitamin D deficiencies are additional and modified risk factors. AEDs may indirectly accelerate bone loss through hypovitaminosis D, hypocalcemia and hyperparathyroidism or reduce bone accrual through decreasing the levels of calcitonin, growth factors and vitamin K. Also, AEDs may directly accelerate osteoclastic (bone loss) and/or reduce osteoblastic (bone formation) activities, the main cells involved in bone remodeling.
  
  
  CONCLUSIONS
  Understanding the basic bone biology and the pathophysiology of the disturbed bone and mineral metabolism in epilepsy will aid in identification and monitoring of patients at risk and in planning appropriate prophylactic and therapeutic measures.
authors.affiliation: Assiut University Hospital, Department of Neurology and Psychiatry, Assiut, P.O.Box 71516, Egypt. hamed_sherifa@yahoo.com
authors.forename: Sherifa A
authors.initials: SA
authors.lastname: Hamed
mesh_terms: D000818:Animals; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D015519:Bone Density / Q000187:drug effects; D001851:Bone Diseases, Metabolic / Q000209:etiology*; D016723:Bone Remodeling / Q000187:drug effects; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism; D004827:Epilepsy / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D010006:Osteoblasts / Q000187:drug effects / Q000378:metabolism; D010010:Osteoclasts / Q000187:drug effects / Q000378:metabolism; D012307:Risk Factors
chemical_list: D000927:Anticonvulsants