Seminars in Pediatric Neurology
Volume 14, Issue 4 , Pages 196-200 , December 2007

Bone Consequences of Epilepsy and Antiepileptic Medications

  • Edgar A. Samaniego, MD
  • ,
  • Raj D. Sheth, MD

      Affiliations

    • Corresponding Author InformationAddress reprint requests to Raj D. Sheth, MD, Department of Neurology, 600 Highland Ave, H6/574 CSC, Madison, WI 53792-5132.

References 

  1. Harden CL. Menopause and bone density issues for women with epilepsy. Neurology. 2003;61(suppl 2):S16–S22
  2. Koppel BS, Harden CL, Nikolov BG, et al. An analysis of lifetime fractures in women with epilepsy. Acta Neurol Scand. 2005;111:225–228
  3. Persson HB, Alberts KA, Farahmand BY, et al. Risk of extremity fractures in adult outpatients with epilepsy. Epilepsia. 2002;43:768–772
  4. Souverein PC, Webb DJ, Petri H, et al. Incidence of fractures among epilepsy patients: A population-based retrospective cohort study in the General Practice Research Database. Epilepsia. 2005;46:304–310
  5. Mattson RH, Gidal BE. Fractures, epilepsy, and antiepileptic drugs. Epilepsy Behav. 2004;5(suppl 2):S36–S40
  6. Drezner MK. Treatment of anticonvulsant drug-induced bone disease. Epilepsy Behav. 2004;5(suppl 2):S41–S47
  7. Petty SJ, Paton LM, O’Brien TJ, et al. Effect of antiepileptic medication on bone mineral measures. Neurology. 2005;65:1358–1365
  8. Appleton RE. Seizure-related injuries in children with newly diagnosed and untreated epilepsy. Epilepsia. 2002;43:764–767
  9. Henderson RC, Lark RK, Gurka MJ, et al. Bone density and metabolism in children and adolescents with moderate to severe cerebral palsy. Pediatrics. 2002;110:e5
  10. Sillanpaa M, Jalava M, Kaleva O, et al. Long-term prognosis of seizures with onset in childhood. N Engl J Med. 1998;338:1715–1722
  11. Sheth RD. Adolescent issues in epilepsy. J Child Neurol. 2002;17(suppl 2):2S23–2S27
  12. Melton LJ, Kan SH, Wahner HW, et al. Lifetime fracture risk: An approach to hip fracture risk assessment based on bone mineral density and age. J Clin Epidemiol. 1988;41:985–994
  13. Sheth RD. Bone health in pediatric epilepsy. Epilepsy Behav. 2004;5(suppl 2):S30–S35
  14. Sheth RD, Binkley N, Hermann BP. Progresive bone deficit in epilepsy. Neurology. 2007;(in press)
  15. Fitzpatrick LA. Pathophysiology of bone loss in patients receiving anticonvulsant therapy. Epilepsy Behav. 2004;5(suppl 2):S3–S15
  16. Pack AM, Morrell MJ, Marcus R, et al. Bone mass and turnover in women with epilepsy on antiepileptic drug monotherapy. Ann Neurol. 2005;57:252–257
  17. Sheth RD. Metabolic concerns associated with antiepileptic medications. Neurology. 2004;63(suppl 4):S24–S29
  18. Sheth RD, Wesolowski CA, Jacob JC, et al. Effect of carbamazepine and valproate on bone mineral density. J Pediatr. 1995;127:256–262
  19. Pack A. Effects of treatment on endocrine function in patients with epilepsy. Curr Treat Options Neurol. 2005;7:273–280
  20. Vestergaard P, Tigaran S, Rejnmark L, et al. Fracture risk is increased in epilepsy. Acta Neurol Scand. 1999;99:269–275
  21. Melton LJ, Crowson CS, O’Fallon WM. Fracture incidence in Olmsted County (Minnesota: Comparison of urban with rural rates and changes in urban rates over time). Osteoporos Int. 1999;9:29–37
  22. Buck D, Baker GA, Jacoby A, et al. Patients’ experiences of injury as a result of epilepsy. Epilepsia. 1997;38:439–444
  23. Sheth RD, Gidal BE, Hermann BP. Pathological fractures in epilepsy. Epilepsy Behav. 2006;9:601–605
  24. Souverein PC, Webb DJ, Weil JG, et al. Use of antiepileptic drugs and risk of fractures: Case-control study among patients with epilepsy. Neurology. 2006;66:1318–1324
  25. Riggs BL, Melton LJ. Involutional osteoporosis. N Engl J Med. 1986;314:1676–1686
  26. Sheth RD. Bone health in epilepsy. Epilepsia. 2002;43:1453–1455
  27. Verrotti A, Greco R, Latini G, et al. Increased bone turnover in prepubertal, pubertal, and postpubertal patients receiving carbamazepine. Epilepsia. 2002;43:1488–1492
  28. Sato Y, Kondo I, Ishida S, et al. Decreased bone mass and increased bone turnover with valproate therapy in adults with epilepsy. Neurology. 2001;57:445–449
  29. Vestergaard P, Rejnmark L, Mosekilde L. Fracture risk associated with use of antiepileptic drugs. Epilepsia. 2004;45:1330–1337
  30. Stephen LJ, McLellan AR, Harrison JH, et al. Bone density and antiepileptic drugs: A case-controlled study. Seizure. 1999;8:339–342
  31. Boluk A, Guzelipek M, Savli H, et al. The effect of valproate on bone mineral density in adult epileptic patients. Pharmacol Res. 2004;50:93–97
  32. Matkovic V, Kostial K, Simonovic I, et al. Bone status and fracture rates in two regions of Yugoslavia. Am J Clin Nutr. 1979;32:540–549
  33. Allen JR, Humphries IR, Waters DL, et al. Decreased bone mineral density in children with phenylketonuria. Am J Clin Nutr. 1994;59:419–422
  34. Lande MB, Kim MS, Bartlett C, et al. Reversible Fanconi syndrome associated with valproate therapy. J Pediatr. 1993;123:320–322
  35. Hawkins E, Brewer E. Renal toxicity induced by valproic acid (Depakene). Pediatr Pathol. 1993;13:863–868
  36. Pack AM, Morrell MJ. Treatment of women with epilepsy. Semin Neurol. 2002;22:289–298
  37. Klein GL, Bachrach LK, Holm IA. Effects of pharmacologic agents on bone in childhood: An editorial overview. Pediatrics. 2007;119(suppl 2):S125–S130
  38. Pack AM. The association between antiepileptic drugs and bone disease. Epilepsy Curr. 2003;3:91–95
  39. Pack AM, Morrell MJ. Adverse effects of antiepileptic drugs on bone structure: Epidemiology, mechanisms and therapeutic implications. CNS Drugs. 2001;15:633–642
  40. Ali II, Schuh L, Barkley GL, Gates JR. Antiepileptic drugs and reduced bone mineral density. Epilepsy Behav. 2004;5:296–300
  41. Valmadrid C, Voorhees C, Litt B, et al. Practice patterns of neurologists regarding bone and mineral effects of antiepileptic drug therapy. Arch Neurol. 2001;58:1369–1374
  42. Guo CY, Ronen GM, Atkinson SA. Long-term valproate and lamotrigine treatment may be a marker for reduced growth and bone mass in children with epilepsy. Epilepsia. 2001;42:1141–1147
  43. Rattya J, Vainionpaa L, Knip M, et al. The effects of valproate, carbamazepine, and oxcarbazepine on growth and sexual maturation in girls with epilepsy. Pediatrics. 1999;103:588–593
  44. Elliott ME, Binkley N. Evaluation and measurement of bone mass. Epilepsy Behav. 2004;5(suppl 2):S16–S23
  45. Fewtrell MS. Bone densitometry in children assessed by dual x ray absorptiometry: Uses and pitfalls. Arch Dis Child. 2003;88:795–798
  46. Russell RG. Bisphosphonates: Mode of action and pharmacology. Pediatrics. 2007;119(suppl 2):S150–S162
  47. Whyte MP, Wenkert D, Clements KL, et al. Bisphosphonate-induced osteopetrosis. N Engl J Med. 2003;349:457–463
  48. Pedrera JD, Canal ML, Carvajal J, et al. Influence of vitamin D administration on bone ultrasound measurements in patients on anticonvulsant therapy. Eur J Clin Invest. 2000;30:895–899
  49. Silver J, Davies TJ, Kupersmitt E, et al. Prevalence and treatment of vitamin D deficiency in children on anticonvulsant drugs. Arch Dis Child. 1974;49:344–350
  50. Mikati MA, Dib L, Yamout B, et al. Two randomized vitamin D trials in ambulatory patients on anticonvulsants: Impact on bone. Neurology. 2006;67:2005–2014

PII: S1071-9091(07)00059-9

doi: 10.1016/j.spen.2007.08.006

Seminars in Pediatric Neurology
Volume 14, Issue 4 , Pages 196-200 , December 2007