Department of Neurology, Maastricht University Medical Centre, Maastricht, The Netherlands; Research school of Mental Health & Neuroscience, Maastricht, The Netherlands; Department of Neurology, Atrium Medical Centre Parkstad, Heerlen, The Netherlands.
Acta Neurol Scand. 2013 Oct;128(4):273-80. doi: 10.1111/ane.12118. Epub 2013 Mar 6.
Long-term antiepileptic drug use is associated with low bone mineral density (BMD), fractures and abnormalities in bone metabolism. We aimed at determining the prevalence of bone mineral disorders in patients with refractory epilepsy treated with antiepileptic drugs.
A cross-sectional survey was conducted in adult patients (n = 205) from a residential unit of a tertiary epilepsy centre. Screening for bone mineral disorders was performed with dual-energy X-ray absorptiometry (DXA) scan of spine and hip (including bone mineral density and vertebral fracture assessment) and laboratory measurements. Patient information regarding demography, epilepsy characteristics and medication use was recorded. Based on DXA T-scores, prevalence of bone mineral disorders (osteopenia and osteoporosis) was calculated. Correlations between DXA T-scores and epilepsy parameters were explored.
Of the 205 patients, there were 10 dropouts. 80% (n = 156/195) of the patients had low BMD: 48.2% had osteopenia and 31.8% had osteoporosis. Of those having low BMD, 51.9% (n = 81/195) was between 18 and 50 years. The T-score of the femoral neck correlated significantly with total duration of epilepsy, cumulative drug load and history of fractures. Linear regression analysis showed that of the epilepsy-related parameters, only cumulative drug load significantly predicted low femoral neck T-score (P = 0.001).
In this high-risk population, we obtained a very high prevalence of 80% of low BMD. Both men and women were affected as well as patients <50 years of age. This study illustrates the magnitude of the problem of bone mineral disorders in chronic epilepsy.
长期使用抗癫痫药物与骨密度降低（BMD）、骨折和骨代谢异常有关。我们旨在确定接受抗癫痫药物治疗的难治性癫痫患者的骨矿物质紊乱的患病率。
对三级癫痫中心的住院单元中的成年患者（n=205）进行了横断面调查。通过脊柱和髋关节的双能 X 射线吸收法（DXA）扫描（包括骨矿物质密度和椎体骨折评估）和实验室测量来筛查骨矿物质疾病。记录患者的人口统计学、癫痫特征和药物使用信息。根据 DXA T 评分，计算骨矿物质疾病（骨质疏松症和骨质疏松症）的患病率。探讨 DXA T 评分与癫痫参数之间的相关性。
在 205 名患者中，有 10 名患者脱落。195 名患者中有 80%（n=156）的 BMD 降低：48.2%患有骨质疏松症，31.8%患有骨质疏松症。在低 BMD 的患者中，51.9%（n=81）年龄在 18 至 50 岁之间。股骨颈的 T 评分与癫痫总病程、累积药物负荷和骨折史显著相关。线性回归分析表明，在与癫痫相关的参数中，只有累积药物负荷显著预测股骨颈低 T 评分（P=0.001）。
在这个高风险人群中，我们获得了非常高的 80%的低 BMD 患病率。男性和女性以及<50 岁的患者均受到影响。这项研究说明了慢性癫痫中骨矿物质疾病问题的严重程度。
