Evidence of Osteomalacia in an Outpatient Group of Adult Epileptics

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Abstract
A review of 50 adult epileptics who had taken anticonvulsant drugs for 10 or more yr showed a decrease in the concentration of serum PO42- and Ca and an increase in the activity of alkaline phosphatase in 22% of the patients. Plasma albumin and .gamma.-globulin levels were higher than in control subjects. All the patients lived at home and the dietary intake of Ca and vitamin D was often borderline normal or low. Of 6 patients submitted to bone biopsy, 4 showed histological osteomalacia. Gastrointestinal disease was not a significant factor. None of the patients had symptoms or signs attributable to osteomalacia which was not of serious significance. All the patients were taking at least 2 drugs and it was not possible to assess the relative importance of the various drugs. Measurements of serum Ca, P and alkaline phosphatase should be performed at intervals on patients who are receiving anticonvulsant therapy. Treatment with calciferol may be indicated.