الفهرس | Only 14 pages are availabe for public view |
Abstract Epilepsy is one of the most common medical conditions that affect children and infants Epileptic treatment goal is long term symptom control, and prevent further seizures. Antiepileptic drugs (AEDs) therapy is considered the primary treatment of epilepsy. yet one of the major concerns are the occurrence of significant metabolic Adverse effects on the bone as AED treatment is given for years and sometimes lifelong. Bone remodeling process involves the proper coupling between bone formation and resorption and this requires proper communication among different bone cells. This is a case control cross-sectional study, conducted in Ain Shams University hospitals, in which 80 child and adolescent epileptic patients were recruited. We assessed metabolic markers of bone metabolism among newly diagnosed patients not on AED and in different treatment groups All patients were subjected to extensive history including, Demographic data: Age, Gender, and Residence. Clinical data: past medical history, age of onset of disease. Medication data: duration of treatment, drug dosage, type of fits, and type of epilepsy. Investigation data: EEG, and MRI abnormalities. Lab data: serum vitamin d levels, parathormone hormone level, calcium total and ionized level, and phosphorous level. As regard laboratory data 67 patients (83.75%) have hyperparathyroidism. Seventy percent of patients have deficiency of vitamin D 4 patients (5%) insufficiency, 15 patients (18.75%) optimal level, and 5 patient (6.25%) toxic level. While 79 patient (98.75%) have hypocalcemia, which is considered an important finding in our study while 23 patients (28.75%) had hyperphosphatemia, and 12 patient (15%) hypophosphatemia. Conclusions: This study shows there is a significant deficiency and insufficiency in vitamin D level, increase in parathormone level, and hypocalcemia in all studied groups. That may reflect a serious problem to be studied in Egyptian pediatrics and adolescent apparently healthy population. Hypocalcemia itself may lead to seizures, or to drug resistant epilepsy in epileptic patients, Also, the correlation between hypocalcemia and epilepsy, whether it is a cause of seizure, a part of pathogenesis, a complication of AEDs, or a coincidence. There is no significant correlation between the use of different AEDs and drug naïve patients regarding the degree of bone metabolism markers affection. With no significant correlation regarding the duration of AEDs administration (1 to 2 years), and the degree of bone metabolism markers affection. So, it is advised that newly diagnosed epileptic patients, and patients on AEDs attending Ain shams hospital pediatric epilepsy clinic, to be kept on prophylactic calcium and vitamin D supplementation. And family education about proper nutrition and son exposure, also about symptoms of hypocalcemia. |