A recent review article highlights possible problems with bone health in children and young people with epilepsy. They may be at a higher risk of broken bones than youngsters without epilepsy – and may benefit from extra vitamin D
The review was done by doctors at Leicester Royal Infirmary’s Department of Paediatric Neurology. Their work shows that bone health in young people with epilepsy may be a bigger problem than was previously thought. These young people may be two or three times more likely to break bones than others their age.
Previous research has shown that epilepsy can affect bone health in some groups. Some anti-epileptic medicines can affect bone metabolism. This is a process that gradually replaces old bone tissue with new tissue – important in healing fractures, for instance. The medicines can prevent the body doing this as effectively as it should.
These medicines can also negatively affect bone density – so that a person’s bones contain less minerals than they should. This makes them easier to break. Previous research has shown increased risks of poor bone-health in older people or menopausal women, for example. However, literature has suggested that young people with epilepsy are not at increased risk of broken bones.
The review from Leicester Royal Infirmary disagrees. While the previous research says that young people are not at a higher risk, the review points out that these older studies only looked at very small numbers of people. They also failed to take into account other factors that could affect bone health in youngsters with epilepsy. These include things like other conditions, how mobile the young person is, what their diet is like and whether they are obese.
The Leicester team say that further research in this area is urgently needed. Still, they say that in the absence of reliable scientific evidence, young people with epilepsy should be prescribed a low-dose vitamin D supplement. This should lower the possible risk of fractures.
In the article was published in The Journal of Paediatric Neurosciences. In it, authors state: “Low-dose vitamin D supplementation… is now recommended for healthy children and it is biologically feasible that children with epilepsy may be at higher risk of clinically significant deficiency. It is important that neurologists ensure that low-dose vitamin D supplementation should be prescribed… in children with epilepsy.”