Abstract
Long-term antiepileptic therapy has an adverse effect on bone metabolism through a number of mechanisms, with the accelerated degradation of vitamin D in cytochrome P 450-inducing antiepileptics being the best documented mechanism. Purpose: Determine calcemia, vitamin D deficiency, osteopenia and osteoporosis in a set of patients on long-term antiepileptic therapy and thus document the need for preventive measures and for the monitoring of bone mineral density (BMD).
Methods: Serum calcium, 25(OH)D3 levels, bone markers and BMD were assessed in a set of 41 outpatient epileptic patients on therapy. The control group included 32 patients hospitalized due to vertebral algic syndromes.
Results: 1. Mean calcemia was in the normal range (2.26 ± 2.97 mmol/l) in the epileptics. 2.
Mean 25(OH)D3 level was 35.61 ± 2.97 nmol/l in the epileptics, with no significant difference between various types of antiepileptic drugs and the control group. 69.4% of the epileptics were vitamin D deficient (<50 nmol/l).3. Osteopenia was found in 58.5% epileptics, osteoporosis in 19.5%, and normal BMD in only 21.9%.