Svalheim S, Røste L S, Nakken K O, Taubøll E
Department of Neurology, Oslo University Hospital-Rikshospitalet, Oslo, Norway.
Acta Neurol Scand Suppl. 2011(191):89-95. doi: 10.1111/j.1600-0404.2011.01551.x.
Patients with epilepsy have a 2-6 times greater risk of bone fractures compared with the general population. There are several potential explanations. Some fractures are caused by seizure-related injuries, or they may be associated with the osteopenic effect of reduced physical activity in patients with epilepsy. Antiepileptic drugs (AEDs), especially those that affect the liver enzymes, e.g., phenytoin, carbamazepine, phenobarbital, as well as valproate, are also associated with increased fracture rate and low bone mineral density. Many patients with epilepsy and general practitioners seem unaware of this problem. Measurements of bone density should be taken regularly in patients at risk of developing osteoporosis. Non-pharmaceutical initiatives, such as partaking in regular physical activity and eating a well-balanced diet, should be recommended. The risk of developing osteoporosis should be taken into consideration in the selection of an AED for treating a newly diagnosed patient with epilepsy.
与普通人群相比，癫痫患者发生骨折的风险要高出2至6倍。对此有几种可能的解释。一些骨折是由癫痫发作相关的损伤引起的，或者可能与癫痫患者身体活动减少导致的骨质减少效应有关。抗癫痫药物（AEDs），尤其是那些影响肝酶的药物，如苯妥英钠、卡马西平、苯巴比妥以及丙戊酸盐，也与骨折率增加和低骨矿物质密度有关。许多癫痫患者和全科医生似乎都没有意识到这个问题。对于有患骨质疏松症风险的患者，应定期进行骨密度测量。应推荐采取非药物措施，如定期进行体育活动和均衡饮食。在为新诊断的癫痫患者选择抗癫痫药物时，应考虑患骨质疏松症的风险。
