Comparison of indices of bone health among Indian adults with drug-resistant versus well-controlled epilepsy: A cross-sectional analytical pilot study

Objectives: An association of antiseizure drugs and the frequency of seizures with abnormalities in bone metabolism resulting in low bone mineral density (BMD) and fractures have been hypothesised. The objective of the study was to compare the indices of bone health between people with drug-resistant and well-controlled epilepsy. Materials and Methods: Forty people each were recruited into two groups for the cross-sectional study. Adults with well-controlled epilepsy formed Group I, whereas adults with refractory epilepsy were included in Group II. Gender- and age-matched people of 18–40 years who had been on antiseizure medications for more than 5 years were included. Smokers, known hypertensive and diabetic patients, people with alcohol use disorder, people with infections or head injuries and lactating women were excluded. Biochemical parameters, fasting glucose, 25OH Vitamin D, C-telopeptide of type 1 collagen, procollagen type 1 N-terminal propeptide, malondialdehyde, total antioxidant status, Ca, P and alkaline phosphatase were estimated. A Hologic dual-energy X-ray absorptiometry scan estimated the total hip, neck of femur and L1 to L4 lumbar spine BMD with trabecular bone scores. Results: The bone health biochemical indices and BMD, as well as the proportion of people with low bone mass and degraded bone at the lumbar spine, were not different between the two groups of people with epilepsy. Conclusion: Bone health appears to be unaffected and was comparable in both well-controlled and drug-resistant people with epilepsy.