Evaluation and management of bone health in children with epilepsy on long-term antiepileptic drugs: United Kingdom survey of paediatric neurologists

Fong, Choong Yi; Mallick, Andrew A; Burren, Christine P; Patel, Jayesh

doi:10.1016/j.ejpn.2011.04.002

Cited by 21 publications

(17 citation statements)

References 35 publications

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“…There are now recommendations of periodic vitamin D blood monitoring and vitamin D supplementation in children on long‐term AEDs . Despite these recommendations, a survey among pediatric neurologists in the United Kingdom highlighted that issues related to bone health in children on long‐term AEDs are often overlooked . Currently in Malaysia, it is not a routine practice for children on long‐term AEDs to receive vitamin D supplementation, and there is no guideline on vitamin D supplementation in these children.…”

mentioning

confidence: 99%

Vitamin D deficiency and its risk factors in Malaysian children with epilepsy

Fong

Kong

Poh³

et al. 2016

Epilepsia

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mentioning

confidence: 99%

Vitamin D deficiency and its risk factors in Malaysian children with epilepsy

Fong

Kong

Poh³

et al. 2016

Epilepsia

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“…In addition, epilepsy itself can impact growth in general. 42 In a recent survey performed in the United Kingdom, many pediatric neurologists do not discuss bone health with children on anticonvulsants and do not give supplementation with vitamin D. 43 More research is needed to understand the complex relationship between bone health and children with epilepsy.…”

Section: Epilepsy Comorbiditiesmentioning

confidence: 99%

Pediatric epilepsy

2012

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Epilepsy in children can be very different from epilepsy in adults, both in seizure type and epilepsy syndrome. The goal in treating children is seizure freedom, no treatment side effects, and function that is no different from the general population. In a significant percentage of patients, this goal remains unachievable, but many aspects of epilepsy are becoming clearer. This review will highlight 5 areas where progress is being made to achieve these goals in pediatric epilepsy. Specific research animal models are being developed to reflect the unique features of different pediatric epilepsies. As genetic syndromes are better identified, for some patients this has led to improved treatment. New advances in drug therapy have led to 3 new medications approved for children. More effective drug choices can now be recommended due to comparative drug trials and better overall care of children can be provided due to awareness of the comorbidities of epilepsy.

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“…It has been found that in the past the majority of pediatric neurologists did not consider the bone health issues of epileptic children [33]. ERBD is not a matter of a single specialty as it is a systematic multifactorial disease and many subspecialties as pediatric orthopedics, pediatric endocrinologists and pediatricians should be involved.…”

Section: Management Of Erbdmentioning

confidence: 99%

“…Annual measure of DXA can be suggested in severe cases and further studies can be organized in order to find which is the appropriate reevaluation time interval for DXA measurement in epileptic children. Moreover, the DXA machine should be equipped with a pediatric analysis software which should assess the age specific z-score for each epileptic child [33]. The specific z-score for the age of each epileptic child under risk of fractures must be evaluated and every child with z-score below -2 and history of undergoing a fracture should begin antiosteoporotic treatment.…”

Section: Management Of Erbdmentioning

confidence: 99%

“…However, the decrease of calcium levels seems to be caused by decreased vitamin D levels due to limited sun exposure or limited prevention through food [5,7]. PTH and phosphate levels are significantly reduced in patients under anticonvulsant treatment [20] and valproate acid usage leads to resistance to PTH and inhibition of calcitonin secretion [33]. Additionally, increased ALP levels are an essential indicator for osteomalacia [16].…”

Section: Aeds and Calcium Phosphate Pth And Alp Levelsmentioning

confidence: 99%

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Metabolic bone disorders in children with epilepsy

Manolis¹,

Lepetsos²,

Tzefronis³

et al. 2017

Rheumatol Orthop Med

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Epilepsy during childhood is the most usual neurological disease and it is characterized by recurrent seizures influencing the everyday life of children. As a treatment, antiepileptic drugs (AEDs) affect the bone metabolism resulting in osteoporosis, osteomalacia, rickets, abnormal dentition and increased rate of fractures. Reduced bone mass density (BMD) has been found in the majority of children with epilepsy and a large proportion of these patients has osteoporosis. Furthermore, in many studies the BMD in the epileptic children is significantly lower than in the healthy one. Overall nutritional status affects the manifestation of seizures and the physiology of bone tissue. Especially the levels of vitamin D and calcium play a vital role in the expression of epilepsy related bone disease (ERBD) in children.In parallel, epileptic children should be adequately mobilized as less physical daily activity and inability to walk independently lead to decreased BMD levels which are the major cause of increased number of fractures. Close monitoring of BMD, nutritional status evaluation and prevention of ERBD is as crucial as treatment of epilepsy with antiepileptic drugs, in order to prevent the expression of fractures. Every specialty involved in the treatment of epileptic children must be aware of the consequences of epilepsy in bone tissue.

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Evaluation and management of bone health in children with epilepsy on long-term antiepileptic drugs: United Kingdom survey of paediatric neurologists

Cited by 21 publications

References 35 publications

Vitamin D deficiency and its risk factors in Malaysian children with epilepsy

Vitamin D deficiency and its risk factors in Malaysian children with epilepsy

Pediatric epilepsy

Metabolic bone disorders in children with epilepsy

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