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Vitamin D and bone health among children with epilepsy
Renée A Shellhaas1, Sucheta M Joshi
1Division of Pediatric Neurology, Department of Pediatrics and Communicable Diseases, University of Michigan, Ann Arbor, MI, USA. shellhaa@med.umich.edu
Insights
Vitamin D deficiency is common in children with epilepsy, increasing bone health risks. This review covers vitamin D metabolism, bone health, and screening strategies for these patients.
Area of Science:
- Pediatric Endocrinology
- Neurology
- Bone Metabolism
Background:
- Growing attention on vitamin D deficiency and insufficiency in scientific and lay literature.
- Low vitamin D levels are linked to abnormal bone mineralization and poor bone health in epilepsy patients.
- Bone health in children with epilepsy is multifactorial, influenced by anticonvulsant medications, epilepsy features, and comorbidities.
Purpose of the Study:
- To review vitamin D metabolism concerning bone health in pediatric epilepsy.
- To discuss existing literature on vitamin D and bone mineral density in children with epilepsy.
- To propose screening and treatment algorithms for vitamin D insufficiency in this population.
Main Methods:
- Literature review focusing on vitamin D metabolism and bone health in pediatric epilepsy.
- Analysis of studies examining vitamin D levels and bone mineral density in children with epilepsy.
- Synthesis of information to develop clinical recommendations.
Main Results:
- Vitamin D deficiency is a significant concern in children with epilepsy, impacting bone health.
- Anticonvulsant drugs and epilepsy-related factors contribute to altered bone metabolism.
- Evidence suggests a link between low vitamin D and reduced bone mineral density in this cohort.
Conclusions:
- Vitamin D status is critical for bone health in children with epilepsy.
- Comprehensive assessment considering anticonvulsant use and comorbidities is necessary.
- Screening and timely treatment of vitamin D insufficiency are recommended for improved bone health outcomes.
Abstract:
The lay media and scientific literature have focused increasing attention on vitamin D deficiency and insufficiency in recent years. Low vitamin D levels confer increased an risk of abnormal bone mineralization, and are linked to poor bone health in epilepsy patients. However, vitamin D is not the only determinant of bone health in children with epilepsy. Anticonvulsant medications, in addition to features and comorbidities of epilepsy and coexisting neurologic diseases, are important factors in this complex topic. We review the basic metabolism of vitamin D in terms of bone health among children with epilepsy. We also discuss the literature regarding vitamin D and bone mineral density in this population. Finally, we suggest algorithms for screening and treating vitamin D insufficiency in these patients.
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