Abstracts

Rationale: More than half of total body weight is lean body mass (LBM), most of which is skeletal muscle. LBM along with body fat are major components of total body weight. LBM can be adversely affected in many chronic illnesses including neurological disorders such as cerebral palsy and stroke. Furthermore, antiepileptic medication can affect body weight and may underlie alteration in endocrine function and contribute to epilepsy associated reproductive comorbidity. In order to examine the impact of epilepsy on LBM we studied normally ambulatory patients with epilepsy and compared their LBM with that of controls. Methods: DEXA methodology was used to measure whole body LBM in 113 normally ambulatory children with epilepsy aged 6 to 18 years and compared to 37 healthy controls. Dietary and activity logs were maintained. IRB approved consent and assent was obtained prior to study. Group comparisons were conducted using Wilcox rank sum test and Spearman rank order correlation coefficient. Nonparametric procedures were used to minimize the effects of outliers on the results. Results: Generally patients with epilepsy had reduced LBM 32,076+11,878 g (95%CI: 29,862 to 34,290 grams) compared to controls 35,990+9,608 g (95%CI: 32,076 to 39,194 grams) (p<0.05). LBM in females was lower compared to female controls (p<0.01). Males had similar LBM to male controls. LBM was significantly lower in patients with symptomatic epilepsies (n=36; 30,031+11,067; p<0.02) compared to control. For patients with idiopathic epilepsy LBM trended lower in idiopathic but was significantly different from controls (n=77; 32,702+11,498; p=NS). Conclusions: LBM is generally reduced in patients with epilepsy, particularly those with symptomatic epilespy. LBM reductions occurred despite normal ambulation. Females with epilepsy had the greatest reductions compared to controls. These data suggests that subtle neurological deficits not enough to impair normal ambulation and weight bearing may however be enough to adversely impact absolute muscle mass. Muscle mass may influence general health and more specifically motor function, coordination and bone health in epilepsy.