Bone mineral density assessment of women on long-term antiepileptic therapy

OBJECTIVE: To study the effect of anticonvulsants on bone mineral density in patients with epilepsy. MATERIAL AND METHODS: The study included 90 women with epilepsy and a control group of 60 healthy women. The subjects' serum levels of parathyroid hormone, alkaline phosphatase, calcium, phosphorus, and vitamin D were measured. Mineral density and bone structure were assessed using dual-energy X-ray absorptiometry (DEXA). RESULTS: In women with epilepsy, the serum levels of calcium, phosphorus, and vitamin D were significantly lower compared to the control group, and the levels of parathyroid hormone and alkaline phosphatase were significantly higher. There was also a statistically significant difference in the DEXA values between study groups. In women with epilepsy who received enzyme-inducing antiepileptic drugs, calcium, phosphorus, and vitamin D levels were significantly lower compared to patients who received enzyme-inhibiting antiepileptic drugs. Bone mineral density was positively correlated with serum micronutrients (calcium, phosphorus, vitamin D) and negatively with serum alkaline phosphatase and duration of therapy. CONCLUSION: Bone tissue disorders are common in patients with epilepsy. These disorders may be associated with prolonged use of antiepileptic drugs, especially enzyme inducers.

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