Effects of Levetiracetam Monotherapy on Vitamin D Status and Serum Calcium in Children with Epilepsy
Asmaa Maher Zidan
Pediatrics Department, Gastroenterology and Clinical Nutrition Unit, Faculty of Medicine, Tanta University, Tanta, Egypt.
Sahar Abd El Azim Abd El Aziz
Pediatrics Department, Neurology Unit, Faculty of Medicine, Tanta University, Tanta, Egypt.
Hesham Ahmed El-Serogy
Clinical Pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
Doaa Mohammed El-Sawy
Pediatrics Department, Gastroenterology and Clinical Nutrition Unit, Faculty of Medicine, Tanta University, Tanta, Egypt.
*Author to whom correspondence should be addressed.
Abstract
Background: Epilepsy is a common neurological disorder that affects people of all ages, races, and social classes, but it can be especially devastating to a growing child. Adults and children experience fractures 2-6 times more frequently than the general population due to the adverse effects of antiepileptic drugs on bone mineral density or vitamin D (Vit. D) levels.
Aim: This study aimed to investigate the effect of levetiracetam monotherapy on Vit. D status and minerals of bone metabolism (serum calcium (S.Ca.), phosphorus (P), and alkaline phosphatase (Alk. P.) in epileptic children.
Patients: Fifty children with epilepsy (27 boys and 23 girls, mean age 7.78 ± 3.66 years), who had generalized (19) or partial seizures (31) and had been treated with levetiracetam monotherapy for at least six months or more, were enrolled in this study. Another thirty healthy children (16 boy and 14 girls, mean age 6.37 ± 3.45), were chosen to serve as a control group.
Results: The mean S.Ca. , P, and 25-OH Vit. D levels were significantly lower in epileptic children treated with levetiracetam than in healthy control children (p-value <0.05), but the mean serum Alk. P. level was significantly higher (p-value < 0.01). This study also showed that there were significant inverse correlations between the serum 25-OH Vit. D levels and both the serum levels (p-value < 0.001) and the duration (p-value < 0.013) of levetiracetam treatment in the epileptic children.
Conclusion: Vit. D deficiency is common in epileptic children without abnormal underlying conditions who have received levetiracetam as a monotherapy for at least six months.
Keywords: Levetiracetam, monotherapy, vitamin D, serum calcium, epilepsy