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Effects of anticonvulsant drug therapy on bone mineral density in a pediatric population
R W Timperlake1, S D Cook, K A Thomas
1Department of Orthopaedic Surgery, Tulane University School of Medicine, New Orleans, LA 70112.
Insights
Epileptic children on phenobarbital or phenytoin showed no significant differences in femoral neck bone density compared to healthy children. Anticonvulsant therapy duration also did not correlate with bone mineral density.
Area of Science:
- Pediatric Endocrinology
- Neurology
- Bone Metabolism
Background:
- Anticonvulsant medications like phenobarbital and phenytoin are commonly prescribed for epilepsy in children.
- Long-term use of certain anticonvulsants has been associated with potential adverse effects on bone health.
- Understanding the impact of these therapies on pediatric bone density is crucial for clinical management.
Purpose of the Study:
- To investigate the effect of phenobarbital and phenytoin therapy on femoral neck bone mineral density in epileptic children.
- To compare bone mineral density in epileptic children undergoing anticonvulsant treatment with age-matched healthy controls.
- To determine if the duration of anticonvulsant therapy or the specific drug used correlates with bone mineral density changes.
Main Methods:
- Dual photon absorptiometry was used to measure bone mineral content and density in the femoral neck area.
- Twenty epileptic outpatients (aged 5-20 years) on phenobarbital or phenytoin were evaluated.
- A control group of 20 healthy children, matched for age, sex, and race, was included for comparison.
Main Results:
- No statistically significant differences in femoral neck bone mineral density were found between epileptic patients and the control group.
- No significant correlation was observed between the duration of anticonvulsant therapy and bone mineral density.
- Bone mineral density values did not differ between epileptic patients receiving phenobarbital and those receiving phenytoin.
Conclusions:
- Phenobarbital and phenytoin therapy, for up to 124 months, did not appear to negatively impact femoral neck bone mineral density in children and adolescents with epilepsy.
- Current anticonvulsant regimens studied do not show a detrimental effect on this specific measure of bone health in the pediatric population.
- Further research may explore other skeletal sites or different anticonvulsant medications.
Abstract:
Twenty epileptic outpatients, aged 5-20 years and taking either phenobarbital or phenytoin for anticonvulsant therapy, were evaluated for femoral neck area bone mineral content and bone mineral density using dual photon absorptiometry. Duration of treatment averaged 51.4 months (range, 9-124 months). A group of 20 normal children who were matched for age, sex, and race served as controls. There were no statistically significant differences between the femoral neck area bone mineral densities of the epileptic patients as compared to the controls. There were also no correlations between duration of anticonvulsant therapy and bone mineral density, nor any differences in bone mineral density values when comparing epileptic patients taking phenobarbital with those patients taking phenytoin.