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Epilepsy Patients on AEDs Unaware of Fracture Risk

by Dr. Reeja Tharu on Jul 16 2012 12:13 PM
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Researchers from the University of Melbourne find that the majority of epilepsy patients are unaware of the fact that taking anti-epileptic drugs (AEDs) predisposes them to falls and fractures.

In a study carried out by an Australian research team on 150 epileptics taking AEDs, only 30% of them knew that these drugs increase their risk for falls, fractures and decrease bone mineral density (BMD) and also, have a negative impact on their bone metabolism.

Though the subjects attended specialist epilepsy clinics, only 23% of them were aware of the fact that most fractures in epilepsy patients were not linked to seizures. However, 70% of the epilepsy patients studied expressed a keen interest to know more about the impact of AEDs on bone health.

Interestingly, the study also helped to confirm the increased fracture risk in AED- administered patients.

The average age of the patients studied was 30 years and they were on AED for nearly 20 years. The subjects were then compared to 506 gender and age-matched patients without epilepsy (non AED –users). It was found that AED users were more predisposed to osteoporosis, spinal fractures, clavicle fractures, and ankle fractures.

It was estimated that each additional year of AED use elevated the patients' fracture risk by 4% for all fractures. The researchers noted that 69% of all fractures that occurred in epileptic patients were not directly related to seizures.

Alison Pack of USA’s Columbia University writes in an editorial that accompanied the study, in Neurology, "This study highlights the need for better education on the risk of fracture, falls, and adverse effects of bone health among persons with epilepsy treated with AEDs."

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"Additional well-designed controlled studies are needed to better understand the effect of epilepsy and AED therapy on osteoporosis and fall and fracture risk. Future studies should determine the differential effect of specific AEDs, particularly given the availability of multiple AED agents," Pack sums up in her editorial.

Reference:
http://onlinelibrary.wiley.com/doi/10.1111/j.1528-1157.1997.tb01733.x/abstract

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