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Osteopenia in cerebral palsy

N J Shaw1, C P White, W D Fraser

  • 1Institute of Child Health, Alder Hey Children's Hospital, Liverpool.

Archives of Disease in Childhood
|September 1, 1994
PubMed
Summary
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Children with cerebral palsy often have low bone mineral density. Bisphosphonate treatment significantly improved bone density in non-ambulant children with cerebral palsy and recurrent fractures.

Area of Science:

  • Pediatric Endocrinology
  • Pediatric Orthopedics
  • Neurology

Background:

  • Non-ambulant children with cerebral palsy (CP) are at high risk for reduced bone mineral density (BMD).
  • This can lead to an increased risk of fractures, impacting mobility and quality of life.
  • The underlying causes of reduced BMD in this population are not fully understood.

Purpose of the Study:

  • To assess bone mineral density (BMD) in non-ambulant children with cerebral palsy (CP).
  • To investigate potential associations with serum 25-hydroxyvitamin D, parathyroid hormone, and urinary calcium excretion.
  • To evaluate the efficacy of bisphosphonate treatment in children with recurrent fractures.

Main Methods:

  • Bone mineral density (BMD) of the lumbar spine was measured in nine non-ambulant children with CP.

Related Experiment Videos

  • Serum levels of 25-hydroxyvitamin D and parathyroid hormone were analyzed.
  • Urinary calcium excretion was measured. Three children with recurrent fractures received bisphosphonate treatment for 12-18 months.

    • Main Results:

    • All children exhibited significantly reduced lumbar spine BMD, even after adjusting for body weight.
    • No consistent abnormalities in vitamin D or parathyroid hormone levels were observed.
    • Three children presented with hypercalciuria. Bisphosphonate treatment in three children resulted in a 20-40% increase in BMD without adverse effects.

    Conclusions:

    • Non-ambulant children with cerebral palsy (CP) have severely reduced bone mineral density (BMD).
    • Bisphosphonate therapy is a safe and effective treatment for improving BMD in CP patients with recurrent fractures.
    • Further research is needed to elucidate the specific mechanisms contributing to low BMD in this population.