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Vitamin D prophylaxis in persons with epilepsy?

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Title: Vitamin D prophylaxis in persons with epilepsy?
Authors: Sourbron, Jo (AUTHOR), Auvin, Stéphane (AUTHOR), Cabral‐Lim, Leonor (AUTHOR), Devlin, Anita (AUTHOR), Dluglos, Dennis (AUTHOR), Hosny, Hassan (AUTHOR), Marson, Tony (AUTHOR), Meador, Kimford J. (AUTHOR), Patel, Archana A. (AUTHOR), Penell, Page B. (AUTHOR), Riney, Kate (AUTHOR), Trinka, Eugen (AUTHOR), Wiebe, Samuel (AUTHOR), Lagae, Lieven (AUTHOR)
Source: Epilepsia (Series 4). Sep2024, Vol. 65 Issue 9, p2567-2579. 13p.
Subjects: Bone densitometry, Bone health, Vitamin D deficiency, Vitamin D, Dietary supplements
Abstract: Limited guidelines exist regarding osteoporosis prevention in the general population. Despite being a subject of controversy, the majority of research suggests that decreased vitamin D levels correlate with increased bone turnover, that is, an important risk factor for osteoporosis development. In most guidelines, daily vitamin D supplementation is recommended. In persons with epilepsy (PWE), the situation is more complex, as other factors can increase the chance of being vitamin D deficient. Currently, there are no internationally accepted guidelines regarding monitoring bone health in PWE. Our aim was to review the existing evidence in PWE on: (1) risk factors for vitamin D deficiency, (2) the identification of higher risk groups, and (3) the optimal ways to monitor bone health. Our narrative review shows that: (1) anti‐seizure medication (ASM) use, especially enzyme‐inducing ASM (EIASM) and valproic acid, is identified as an important risk factor for impaired bone health (e.g., increased risk for osteoporosis/fractures and/or vitamin D deficiency); (2) higher risk groups within the PWE population are present: intellectual or physical disability, institutionalized patients, puberty, early onset epilepsy and developmental epileptic encephalopathies, postmenopausal women, and use of multiple ASM/concomitant drugs (e.g. corticosteroids); and (3) a monitoring scheme can be suggested including laboratory tests, bone density measurements, managing of risk factors, and/or vitamin D supplementation. Overall, regular vitamin D measurement in PWE is a cost‐effective and practical method for monitoring vitamin D deficiency, whereas in high‐risk patients the combination of vitamin D measurement and bone densitometry is recommended. There is not enough evidence to advocate continuous vitamin D supplementation in all PWE. Children with epilepsy should receive the recommended daily intake of vitamin D for age and additional monitoring and supplementation if at higher risk of deficiency. There is a need for prospective trials exploring the potential benefit of vitamin D supplementation in PWE. [ABSTRACT FROM AUTHOR]
Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: Vitamin D prophylaxis in persons with epilepsy?
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  Data: <searchLink fieldCode="AR" term="%22Sourbron%2C+Jo%22">Sourbron, Jo</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Auvin%2C+Stéphane%22">Auvin, Stéphane</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Cabral‐Lim%2C+Leonor%22">Cabral‐Lim, Leonor</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Devlin%2C+Anita%22">Devlin, Anita</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Dluglos%2C+Dennis%22">Dluglos, Dennis</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Hosny%2C+Hassan%22">Hosny, Hassan</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Marson%2C+Tony%22">Marson, Tony</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Meador%2C+Kimford+J%2E%22">Meador, Kimford J.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Patel%2C+Archana+A%2E%22">Patel, Archana A.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Penell%2C+Page+B%2E%22">Penell, Page B.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Riney%2C+Kate%22">Riney, Kate</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Trinka%2C+Eugen%22">Trinka, Eugen</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Wiebe%2C+Samuel%22">Wiebe, Samuel</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Lagae%2C+Lieven%22">Lagae, Lieven</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Epilepsia+%28Series+4%29%22">Epilepsia (Series 4)</searchLink>. Sep2024, Vol. 65 Issue 9, p2567-2579. 13p.
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  Data: <searchLink fieldCode="DE" term="%22Bone+densitometry%22">Bone densitometry</searchLink><br /><searchLink fieldCode="DE" term="%22Bone+health%22">Bone health</searchLink><br /><searchLink fieldCode="DE" term="%22Vitamin+D+deficiency%22">Vitamin D deficiency</searchLink><br /><searchLink fieldCode="DE" term="%22Vitamin+D%22">Vitamin D</searchLink><br /><searchLink fieldCode="DE" term="%22Dietary+supplements%22">Dietary supplements</searchLink>
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  Data: Limited guidelines exist regarding osteoporosis prevention in the general population. Despite being a subject of controversy, the majority of research suggests that decreased vitamin D levels correlate with increased bone turnover, that is, an important risk factor for osteoporosis development. In most guidelines, daily vitamin D supplementation is recommended. In persons with epilepsy (PWE), the situation is more complex, as other factors can increase the chance of being vitamin D deficient. Currently, there are no internationally accepted guidelines regarding monitoring bone health in PWE. Our aim was to review the existing evidence in PWE on: (1) risk factors for vitamin D deficiency, (2) the identification of higher risk groups, and (3) the optimal ways to monitor bone health. Our narrative review shows that: (1) anti‐seizure medication (ASM) use, especially enzyme‐inducing ASM (EIASM) and valproic acid, is identified as an important risk factor for impaired bone health (e.g., increased risk for osteoporosis/fractures and/or vitamin D deficiency); (2) higher risk groups within the PWE population are present: intellectual or physical disability, institutionalized patients, puberty, early onset epilepsy and developmental epileptic encephalopathies, postmenopausal women, and use of multiple ASM/concomitant drugs (e.g. corticosteroids); and (3) a monitoring scheme can be suggested including laboratory tests, bone density measurements, managing of risk factors, and/or vitamin D supplementation. Overall, regular vitamin D measurement in PWE is a cost‐effective and practical method for monitoring vitamin D deficiency, whereas in high‐risk patients the combination of vitamin D measurement and bone densitometry is recommended. There is not enough evidence to advocate continuous vitamin D supplementation in all PWE. Children with epilepsy should receive the recommended daily intake of vitamin D for age and additional monitoring and supplementation if at higher risk of deficiency. There is a need for prospective trials exploring the potential benefit of vitamin D supplementation in PWE. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1111/epi.18046
    Languages:
      – Code: eng
        Text: English
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      Pagination:
        PageCount: 13
        StartPage: 2567
    Subjects:
      – SubjectFull: Bone densitometry
        Type: general
      – SubjectFull: Bone health
        Type: general
      – SubjectFull: Vitamin D deficiency
        Type: general
      – SubjectFull: Vitamin D
        Type: general
      – SubjectFull: Dietary supplements
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      – TitleFull: Vitamin D prophylaxis in persons with epilepsy?
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              M: 09
              Text: Sep2024
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              Y: 2024
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