title: Bone mineral density and vitamin D status in children with epilepsy, cerebral palsy, and cerebral palsy with epilepsy.
abstract: OBJECTIVE
  We aimed to evaluate the relationship between bone mineral density (BMD) disorders and possible risk factors in patients with epilepsy only (EO), cerebral palsy only (CPO), and cerebral palsy-epilepsy (CP + E).
  
  
  METHODS
  A total of 122 patients [EO (n = 54), CPO (n = 30), CP + E (n = 38)] and 30 healthy children were evaluated. BMD was only measured in patient groups, not in control subjects. BMD of lumbar vertebrae was determined by dual energy X-ray absorptiometry (DXA). An abnormal BMD was defined as low or low normal BMD.
  
  
  RESULTS
  Low BMD rate in EO, CPO, and CP + E group was 3.7, 50, and 39.5 %, respectively. Abnormal BMD values were significantly related to inadequate dietary Ca intake (p = 0.017), severe intellectual disability (p < 0.001), and immobility (p = 0.018). In multivariate regression analysis, the risk of abnormal BMD was higher (3.9-fold) in patients not able to walk independently than the others (p = 0.029). However, serum Ca-Vitamin D levels, insufficient exposure to sunlight, low BMI, and use of AED were not correlated with abnormal BMD.
  
  
  CONCLUSIONS
  Abnormal BMD is a common problem in patients with CP and CP + E. Abnormal BMD was related to the severity of CP, but not to vitamin D levels or AED treatment.
authors.affiliation: Department of Pediatrics, Division of Child Neurology, Medical School, Adnan MenderesUniversity, 09100, Kepez, Aydin, Turkey. aysetosun2000@yahoo.com.
authors.forename: Ayse
authors.initials: A
authors.lastname: Tosun
authors.affiliation: Department of Pediatrics, Ataturk State Hospital, Duzce, Turkey.
authors.forename: Seda
authors.initials: S
authors.lastname: Erisen Karaca
authors.affiliation: Department of Pediatric Endocrinology, School of Medicine, Adnan Menderes University, Aydin, Turkey.
authors.forename: Tolga
authors.initials: T
authors.lastname: Unuvar
authors.affiliation: Department of Nuclear Medicine, School of Medicine, Adnan Menderes University, Aydin, Turkey.
authors.forename: Yakup
authors.initials: Y
authors.lastname: Yurekli
authors.affiliation: Department of Biochemistry, School of Medicine, Adnan Menderes University, Aydin, Turkey.
authors.forename: Cigdem
authors.initials: C
authors.lastname: Yenisey
authors.affiliation: Department of Biostatistics and Medical Informatics, School of Medicine, Adnan Menderes University, Aydin, Turkey.
authors.forename: Imran Kurt
authors.initials: IK
authors.lastname: Omurlu
mesh_terms: D015502:Absorptiometry, Photon; D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D015519:Bone Density; D002547:Cerebral Palsy / Q000097:blood / Q000150:complications*; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D012307:Risk Factors; D014807:Vitamin D / Q000097:blood*
chemical_list: D000927:Anticonvulsants; D014807:Vitamin D
keywords: Bone mineral density; Cerebral palsy; Children; Epilepsy; Vitamin D