Abstracts

Rationale: There is a growing awareness of the importance of vitamin D status in epilepsy patients. Low vitamin D levels and the associated reduction in bone mineralization potentially increase the risk of bone injury in children who may fall due to seizures or from the underlying neurologic condition. Antiepileptic drugs may contribute to poor bone health through effects on hepatic metabolism of vitamin D. The objectives of this study are to determine the frequency of vitamin D insufficiency in children with refractory epilepsy and assess potential risk factors.Methods: Children under the age of 18 years wtih refractory epilepsy evaluated for initiation of the ketogenic diet were included in the study. All children had laboratory tests including Vitamin D (25-OH vitamin D and 1,25-OH vitamin D), calcium, and phosphate levels prior to initiating the diet. The ketogenic diet clinic records were reviewed. Data collected includes demographic information, epilepsy type, antiepileptic drugs used, and 25-OH vitamin D level. Vitamin D insufficiency is defined as 25-OH vitamin D level below 32 ng/ml.Results: Twenty seven patients (18 boys and 9 girls) were included in the study. Age ranged between 1 month and 16 years. The 25-OH vitamin D level ranged between 13-55 ng/ml; 40.7% had values below 32. On univariate analysis no association was found between vitamin D insufficiency and age, gender, type of sz, and antiepileptic drugs used. Conclusions: Vitamin D insufficiency was present in two fifths of patients with medically refractory epilepsy. While the lack of association of vitamin D insufficiency with several known risk factors may be related to a small sample size, the finding underscores the importance of screening all patients with refractory epilepsy for vitamin D status.