Clinic of Child Neuropsychiatry, University of Salerno, Salerno, Italy.
Epilepsia. 2012 Dec;53(12):2172-7. doi: 10.1111/j.1528-1167.2012.03639.x. Epub 2012 Sep 7.
The present study aimed to assess bone mineral density (BMD) in a population of children and adolescents with cerebral palsy and mental retardation with or without epilepsy.
One hundred thirteen patients (63 male and 50 female) were recruited for evaluation. Patients were divided in three groups: 40 patients (group 1) were affected by cerebral palsy and mental retardation; 47 (group 2) by cerebral palsy, mental retardation, and epilepsy; and 26 (group 3) by epilepsy. The control group consisted of 63 healthy children and adolescents. Patients underwent a dual-energy x-ray absorptiometry (DEXA) scan of the lumbar spine (L1-L4), and z-score was calculated for each patient; t-score was considered for patients 18 years of age and older.
Abnormal BMD by DEXA was found in 17 patients (42.5%) in group 1, in 33 (70.2%) in group 2, and in 3 (11.5%) in group 3. In groups 1 and 2, tetraparesis and severe/profound mental retardation were related to a significantly abnormal BMD (p = 0.003). The multivariate analysis of independent factors on BMD (z-score) revealed a significant correlation between BMD (z-score) and age (p = 0.04), body mass index (BMI; p = 0.002), severe/profound mental retardation (p = 0.03), and epilepsy (p = 0.05).
A significantly lower BMD z-score value was found in patients with cerebral palsy, mental retardation, and epilepsy compared with those without epilepsy. The epileptic disorder appears to be an aggravating factor on bone health when comorbid with cerebral palsy and mental retardation.
本研究旨在评估脑瘫伴智力障碍且伴或不伴癫痫的患儿骨密度（BMD）。
共招募 113 名患者（男 63 例，女 50 例）进行评估。患者分为三组：40 例（组 1）为脑瘫伴智力障碍；47 例（组 2）为脑瘫伴智力障碍和癫痫；26 例（组 3）为癫痫。对照组由 63 名健康儿童和青少年组成。所有患者均行腰椎（L1-L4）双能 X 线吸收法（DEXA）扫描，计算每位患者的 Z 评分；年龄≥ 18 岁的患者采用 T 评分。
组 1 中 17 例（42.5%）、组 2 中 33 例（70.2%）、组 3 中 3 例（11.5%）存在 DEXA 异常的 BMD。四肢瘫和严重/重度智力障碍与组 1 和组 2 中明显异常的 BMD 显著相关（p = 0.003）。对 BMD（Z 评分）的独立因素进行多元分析显示，BMD（Z 评分）与年龄（p = 0.04）、体重指数（BMI；p = 0.002）、严重/重度智力障碍（p = 0.03）和癫痫（p = 0.05）有显著相关性。
脑瘫伴智力障碍且伴癫痫的患者的 BMD z 评分明显低于无癫痫的患者。当癫痫与脑瘫和智力障碍并存时，癫痫似乎是一个加重骨骼健康的因素。
