Children on Anti Epileptic Drugs Have Low Serum Calcium and Raised Alkaline Phosphatase Levels

Abstract

Objective: Epilepsy is a common neurological disorder in children requiring long-term therapy using anti-epileptic drugs (AEDs). Chronic use of AEDs may impair bone health. This study aimed to determine the biochemical changes affecting bone metabolism in pediatric epileptic patients taking AEDs. Materials and Methods: This cross-sectional study was conducted in the Department of Pediatrics of Benazir Bhutto Hospital, Rawalpindi from January 2019 to July 2019. A total of 95 children were enrolled based on non-probability consecutive sampling technique. Bone metabolism was evaluated by measuring serum calcium and alkaline phosphatase levels in all the study participants. Data was entered on SPSS v 22 and descriptive statistics were applied. Results: Of 95 epileptic children, 50.53% (n=48) were male and 49.47% (n=47) were females taking AEDs (either carbamazepine, valproate sodium or phenobarbital), 47.37% (n=45) were between 2-6 years of age while 52.63% (n=50) were between 7-11 years of age (Mean age: 6.53±2.54 years). Mean calcium and alkaline phosphatase levels of patients were calculated as 7.94±2.3 mg/dl and 226.31±17.45 IU/L respectively. Frequency of hypocalcemia in patients taking AEDs was recorded in 67.37% (n=64) and 81.05% (n=77) had raised alkaline phosphatase levels. Conclusion: This study concludes that frequency of hypocalcemia and raised alkaline phosphatase levels in patients taking AEDs is higher and needs attention to address this issue while the magnitude recorded in this study is primary in local population which needs to be re-assessed through multi-center trials.