Related Experiment Video
Updated: Feb 23, 2026
Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
Published on: January 29, 2018
Bone Mineral Status in Children with Epilepsy: Biochemical and Radiologic Markers
Bothina Hasaneen1, Riad Moustafa Elsayed1, Nanees Salem2
1Department of Pediatric, Pediatric Neurology Unit, Mansoura University, Mansoura, Egypt.
Insights
Children on antiepileptic drugs (AEDs) experience altered bone mineral status, with longer treatment durations and multiple AEDs worsening effects on bone density. Dual-energy X-ray absorptiometry (DXA) is a safe method for assessment.
Area of Science:
- Pediatric Endocrinology
- Neurology
- Radiology
Background:
- Epilepsy treatment often involves antiepileptic drugs (AEDs).
- Long-term AED use may impact bone health in children.
- Assessing bone mineral status is crucial for children with epilepsy.
Purpose of the Study:
- To evaluate bone mineral status in children with epilepsy on various AED regimens.
- To compare bone mineral density (BMD) and biochemical markers between epileptic children and controls.
- To investigate the influence of AED duration and type on bone health.
Main Methods:
- Observational prospective controlled cohort study.
- 152 children (ages 3-13 years): 70 with epilepsy, 82 controls.
- Bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA); serum calcium, phosphorus, alkaline phosphatase (ALP), and parathyroid hormone (PTH) measured.
Main Results:
- Children with epilepsy showed significantly lower serum calcium and phosphorus levels compared to controls.
- Elevated serum ALP and PTH levels were observed in epileptic children.
- Significantly decreased total body and lumbar BMD and Z-scores in epileptic children.
Conclusions:
- All AEDs negatively affect bone mineral status in children treated for over 6 months.
- Longer AED treatment duration (≥2 years) and polytherapy are associated with more severe bone density reduction.
- DXA is a safe, non-invasive tool for monitoring BMD in children on long-term AED therapy.
Objective:
The aim of this study is to assess bone mineral status in children with epilepsy, on different antiepileptic drugs (AEDs) regimen, using dual-energy X-ray absorptiometry (DXA) and routine biochemical bone markers.
Patients And Methods:
This is observational prospective controlled cohort study, conducted at Mansoura University Children Hospital, from January 2014 to June 2015. In this study, we had 152 participants with ages 3-13 years, 70 children diagnosed with epilepsy and 82 were controls. Children classified into two groups according to the duration of treatment, Group 1 children maintained on AEDs for 6-24 months, Group 2 children ≥24 months. Bone mineral density (BMD) measured by DXA and biochemical markers includes serum calcium, phosphorus, alkaline phosphatase (ALP), and parathyroid hormone (PTH).
Results:
In this study, we found that the serum level of calcium and phosphate were significantly low (P > 0.05) in total cases versus control. We found that the serum level of and ALP and PTH were significantly high (P > 0.05) in total cases versus control. Regarding the DXA markers, there was a significant decrease of BMD and Z-score for the total body and lumbar area in the total cases versus control (P > 0.05).
Conclusion:
The present study showed that all AEDs (new and old) affect bone mineral status in children receiving therapy for more than 6 months, altering both biochemical markers (serum calcium, phosphorus, ALP, and PTH) and radiologic markers (BMD assessed using DXA). Children on AEDs for a longer duration (≥2 years) showed more severe side effects on BMD. Children receiving multiple AEDs are more prone to altered bone mineral status, especially with long duration of therapy. The study also highlights the role of DXA as a safe noninvasive method to assess BMD in children on long-term AEDs.
