Abstracts

Rationale: This descriptive study was undertaken to retrospectively review the variables associated with bone health in a population of veterans followed by the Durham VA Epilepsy Center. Methods: The Neurodiagnostic Center at the Durham VA Medical Center has been providing epilepsy services to veterans since the early 1970's. A review of all patients that are actively followed during the years of 2006 to 2009 were followed. Many of these patients have as long as a thirty year history with our center. Pertinent data such as the exact date of introduction of a specific AED and exact years with epilepsy were retrieved with a high degree of certainty because of this careful record keeping process. All 218 patients were requested to undergo a measurement of bone mineral density as measured by DEXA(Dual Energy X-ray absorptiometry)between the years of 2006 and 2009 and had documentation of medication use, years of use, combinations of medication type, BMI measurements and the maximum number of anti epileptic drugs used per individual patient. Results: 218 veterans records were retrospectively studied. 153 veterans completed the DEXA scan. There were 152 femoral neck measurements and 148 lumbar Spine measurements. The percentage of veterans with bone mineral density changes as measured by the WHO classification were as follows: 7 of the 152 femoral neck measurements revealed osteoporosis with t scores below -2.5(4.6%). 11 of the 148 lumbar spine measurements had a T score below -2.5. (7.4%). The following percentage of patients had abnormalities consistent with WHO criteria for osteopenia. T score below -1.0 but above -2.5. femoral neck osteopenia was found in 66 of 152 patients(43%) and lumbar spine osteopenia was found in 51 of 148 patients (34%). The following demographic variables were studied. Age, gender, years with epilepsy, BMI, and maximum number of anti epileptic drugs used in combination. See table 1. The exact anti-epileptic drug combination type was reviewed for all patients with femoral neck measurements taken. (N=152) and for all patients with lumbar spine measurments taken (N-148). The drug group combination information was looked at in both normal femoral neck and lumbar spine measurement groups and with abnormal femoral neck and lumbar spine bone loss groups. Groups of combination AED type were studied accordingly: EIAED alone group, EIAED with EIAED group, EIAED with NEIAED group, NEIAED with NEIAED group, and NEIAED alone group. See table 2. Conclusions: A retrospective look at bone mineral density loss in veterans with epilepsy revealed a significant presence of bone loss which supports the findings of other investigators who noted bone density changes in people with epilepsy. The study did not look at seizure control to see if this was a possible variable contributing to bone loss. One might indirectly deduce that users of 3-4 AEDS had more difficult to control epilepsy than veterans who used 1-2 AEDS and this study did not review epilepsy burden or separate it from medication burden.