vitamin-d-2 and Epilepsy

Topics: Anticonvulsants; Calcium; Carbamazepine; Cholecalciferol; Epilepsy; Ergocalciferols; Female; Humans; Reference Values; Vitamin D

Children with epilepsy are at increased risk of vitamin D deficiency. We aimed to compare the effect of two ergocalciferol regimens given for 90 days.. Epileptic patients aged 5-18 years who received at least one antiepileptic drug (AED) for more than 6 months and had serum 25-OHD <30 ng/mL were randomized to receive 20,000 IU/10 d (standard dose, n=41) or 60,000 IU/10 d (high dose, n=41) of oral ergocalciferol. Serum Ca, P, Mg, ALP, iPTH and urine Ca/Cr ratio were measured at baseline and after 90 days of treatment. Change in serum 25-OHD and vitamin D status after treatment was evaluated.. The initial serum 25-OHD in the standard dose and high dose group was 19.5 ± 4.9 and 18.4 ± 4.6 ng/mL, respectively. Serum 25-OHD after treatment was significantly higher in the high dose group (39.0 ± 11.5 vs. 27.5 ± 8.6 ng/mL, p<0.05). The average increase in serum 25-OHD in the high dose and standard dose group was 20.6 ± 11.4 and 7.2 ± 7.5 ng/mL, respectively (p<0.05). Normalized serum 25-OHD was achieved in 80.5% of the high dose group compared to 36.6% of the standard dose group (p<0.05). No adverse events were found. Patients with a BMI Z-score>0 had a 2.5 times greater risk of continued hypovitaminosis D after treatment compared to those with a BMI Z-score<0 (95% CI: 1.0-5.9, p<0.05).. Oral ergocalciferol 60,000 IU/10 d for 90 days was more effective at normalizing serum 25-OHD than 20,000 IU/10 d in epileptic children and adolescents who were receiving AEDs.

Topics: Adolescent; Child; Epilepsy; Ergocalciferols; Humans; Rickets; Vitamin D; Vitamin D Deficiency; Vitamins

Bone mineral content(BMC), serum calcium, phosphorus and AKP were measured in 64 epileptic patients on long-term treatment with antiepileptics and in 14 epileptic patients not taking antiepileptics. All these indices were also measured in a group of healthy controls. In the epileptic patients taking antiepileptics BMC was significantly lower than that in the control group. Serum calcium and phosphorus were also lower than normal, while AKP was elevated. In the epileptic patients not taking antiepileptics BMC was not significantly different from that in the control group. Serum calcium, phosphorus and AKP were all normal. After 3 months of treatment with vitamin D2, BMC and serum calcium level returned to normal, but AKP was still significantly lowered.

Topics: Adolescent; Adult; Anticonvulsants; Bone Density; Bone Diseases, Metabolic; Child; Child, Preschool; Epilepsy; Ergocalciferols; Female; Humans; Male; Middle Aged

We examined the effect of short-term treatment with pharmacological doses of vitamin D2 or vitamin D3 on the serum concentration of 1,25(OH)2D metabolites in epileptic patients on chronic anticonvulsant drug therapy. Nine patients were studied before and after treatment with vitamin D2 4000 IU daily for 24 weeks and 10 before and after treatment with vitamin D3 in the same dose. Before treatment the serum concentrations of 1,25(OH)2D and 25(OH)D were significantly lower in epileptics than in normal subjects (P less than 0.01). Vitamin D2 treatment increased the serum concentration of 1,25(OH)2D2, but a corresponding decrease in 1,25(OH)2D3 resulted in an unchanged serum concentration of total 1,25(OH)2D. The serum concentration of 25(OH)D2 and 25(OH)D increased significantly, whereas there was a small decrease in 25(OH)D3. Vitamin D3 treatment did not change the serum concentration of 1,25(OH)2D3 whereas serum 25(OH)D3 increased significantly. The correlation between the serum ratio of 1,25(OH)2D2/1,25(OH)2D3 and 25(OH)D2/25(OH)D3 estimated on vitamin D2-treated epileptic patients and normal subjects was highly significant (P less than 0.01). The data indicate that the serum concentration of 1,25(OH)2D2 and 1,25(OH)2D3 are directly proportional to the amount of their precursors 25(OH)D2 and 25(OH)D3 and that the concentration of total 1,25(OH)2D is tightly regulated.

Topics: 25-Hydroxyvitamin D 2; Adult; Aged; Anticonvulsants; Calcifediol; Calcium; Cholecalciferol; Clinical Trials as Topic; Double-Blind Method; Epilepsy; Ergocalciferols; Female; Humans; Male; Middle Aged; Random Allocation

Topics: Adult; Aged; Clinical Trials as Topic; Drug Interactions; Epilepsy; Ergocalciferols; Female; Humans; Male; Middle Aged; Phenytoin; Placebos; Stimulation, Chemical

Topics: Adult; Alkaline Phosphatase; Anticonvulsants; Calcium; Clinical Trials as Topic; Epilepsy; Ergocalciferols; Female; Humans; Hydroxycholecalciferols; Hypocalcemia; Isoenzymes; Male; Phenobarbital; Phenytoin; Phosphates; Serum Albumin; Sunlight; Time Factors; Vitamin D

Epilepsy is a disease characterized by seizures which impair human life considerably. Vitamin D is of different systemic effects on metabolism and its deficiency is known to have a high prevalence among epilepsy patients. Paricalcitol, a vitamin D receptor agonist, has relatively fewer side effects. This study aimed to investigate the anticonvulsant effect of vitamin D. Vitamin D. Results indicate that vitamin D

Topics: Animals; Disease Models, Animal; Dose-Response Relationship, Drug; Epilepsy; Ergocalciferols; Male; Penicillins; Rats; Rats, Wistar; Seizures; Vitamin D

Topics: Anticonvulsants; Epilepsy; Ergocalciferols; Female; Femoral Neck Fractures; Follow-Up Studies; Fractures, Spontaneous; Humans; Mental Disorders; Middle Aged; Osteoporosis; Phenobarbital; Phenytoin; Treatment Outcome; Valproic Acid; Vitamin D; Vitamin D Deficiency

Serum concentrations of vitamin D metabolites were measured before and during treatment with either vitamin D2 or vitamin D3, 4000 IU per day for 24 weeks, in 22 epileptic outpatients receiving phenobarbitone/phenytoin. The serum concentration of total 1,25(OH)2D did not change during the treatment period in any of the treatment groups. On the other hand, in the vitamin D2 group, serum 25(OH)D2, total 25(OH)D, and 24,25(OH)2D increased significantly during the trial, whereas serum concentrations of the vitamin D3 metabolites were unchanged. In the vitamin D3 group, serum concentrations of the vitamin D3 metabolites increased significantly, whereas the vitamin D3 metabolite levels remained unchanged. However, vitamin D3 treatment resulted in a 2-4-fold greater increase in serum concentrations compared to vitamin D2 treatment. Treatment with vitamin D2 and vitamin D3 in the same dose in IU results in considerably different serum concentrations of the vitamin D metabolites.

Topics: 24,25-Dihydroxyvitamin D 3; 25-Hydroxyvitamin D 2; Adult; Aged; Calcifediol; Calcium; Cholecalciferol; Dihydroxycholecalciferols; Epilepsy; Ergocalciferols; Female; Humans; Male; Middle Aged; Phenobarbital; Phenytoin

Serum concentrations of vitamin D metabolites were measured in 30 epileptic outpatients on monotherapy with carbamazepine before and during treatment with either vitamin D2 or vitamin D3, 4000 IU per day for 24 weeks. Vitamin D2 treatment increased the serum concentration of 25OHD2, but a corresponding decrease in 25OHD3 resulted in an unchanged serum value of total 25OHD. Vitamin D3 treatment increased the serum concentration of 25OHD3. The resulting serum level of 25OHD was consequently twice the level of that in the D2-treated group. The serum concentrations of the dihydroxy metabolites showed a similar difference between the 2 treatment groups. We conclude that treatment with vitamins D2 and D3 in the same doses produces considerably different serum concentrations of vitamin D metabolites. If the present findings can be extrapolated to normal subjects, it is important to consider more carefully which D-vitamin should be used, both with regard to therapy and supplementation.

Topics: Adult; Aged; Carbamazepine; Cholecalciferol; Epilepsy; Ergocalciferols; Female; Humans; Male; Middle Aged

In 22 epileptic outpatients treated for at least 1 year with phenobarbitone/phenytoin the local and total bone mass, together with serum and urinary indices of calcium metabolism, were measured before and during treatment with either vitamin D2 or D3, 4,000 IU daily for 24 weeks. The results showed a distinct difference in the action of the two vitamins on bone metabolism during anti-convulsant treatment. The bone mass increased during treatment with vitamin D2, whereas the vitamin D3-treated patients showed unchanged values of bone mass, but an increased excretion rate of calcium, probably caused by increased intestinal calcium absorption. The data demonstrate that vitamins D2 and D3 (or their metabolites) have quantitative different effects in patients treated with phenobarbitone/phenytoin.

Topics: Adult; Alkaline Phosphatase; Bone and Bones; Calcium; Cholecalciferol; Double-Blind Method; Epilepsy; Ergocalciferols; Humans; Hydroxyproline; Middle Aged; Parathyroid Hormone; Phenobarbital; Phenytoin

In order to clarify whether carbamazepine causes disturbances in calcium and bone metabolism were examined the effect of vitamin D2 or D3 in 30 epileptic outpatients. They had been treated for at least 1 year with carbamazepine given as monotherapy. The local bone mineral in the forearms and the total bone mineral was measured before and during treatment with the vitamins (4000 IU/day) for 24 weeks. The bone mineral was not significantly different from controls before the study and it remained unchanged in both treatment groups during the study periods. Similarly, the biochemical indices of bone metabolism were virtually unchanged during the treatment period. We, thus, conclude that epileptic patients on carbamazepine monotherapy have normal bone metabolism.

Topics: Adult; Aged; Bone and Bones; Carbamazepine; Cholecalciferol; Epilepsy; Ergocalciferols; Female; Humans; Male; Middle Aged; Minerals; Osteomalacia; Vitamin D

In a survey of 108 subjects with a history of epilepsy in a hospital for the mentally handicapped, administration of both phenobarbitone and phenytoin was associated with low serum calcium and plasma 25-hydroxyvitamin D (25-(OH)D) levels in female subjects only. Intake of phenytoin (as mg/kg body weight) in female subjects exceeded that in males by 22 per cent, whilst the intake of phenobarbitone was 37 per cent higher. The doses of phenobarbitone and phenytoin were each inversely related to plasma 25-(OH)D concentration, but anticonvulsant drug dosage did not correlate with the magnitude of the decline of plasma 25-(OH)D concentration in winter (November-February). No influence of sodium valproate was detected on serum calcium or on plasma 25-(OH)D levels. Limited exposure to ultraviolet irradiation (UVR) or oral administration of vitamin D restored plasma 25-(OH)D to normal levels and healed osteomalacia in a subject with tuberous sclerosis. In this subject, fit frequency declined in response to UVR and to a lesser extent in response to oral vitamin D, despite the attainment of similar levels of serum calcium and of plasma 25-(OH)D. Serum calcium levels in the other 108 subjects were lower in those experiencing the most frequent fits, but serum calcium could not be restored to levels found in subjects not receiving anticonvulsant drugs unless supraphysiological doses of vitamin D were given. Vitamin D deficiency in the epileptic population receiving drugs was assessed by the response of alkaline phosphatase to vitamin D administration. A consistent fall of serum alkaline phosphatase was found only if the initial level exceeded 175 per cent of the normal value established by reference to a population not receiving phenobarbitone or phenytoin. By this criterion five out of 45 subjects (11 per cent), aged nine to 36 years were vitamin D deficient.

Topics: 25-Hydroxyvitamin D 2; Adolescent; Adult; Alkaline Phosphatase; Anticonvulsants; Calcium; Child; Epilepsy; Ergocalciferols; Female; Humans; Male; Risk; Sex Factors; Vitamin D; Vitamin D Deficiency

The efficacy of vitamin D2 in the dose of 2000 IU daily in reversing anticonvulsant osteomalacia was studied in nine epileptic inpatients. The treatment with vitamin D2 was associated with increased serum 25-hydroxycalciferol and 24,25-dihydroxyvitamin D concentrations and partial healing of osteomalacic changes in the cancellous bone of the iliac crest. But it was concluded that the dose of vitamin D2, 2000 IU daily, was too small and that calcium supplementation may be needed in addition to vitamin D therapy.

Topics: 24,25-Dihydroxyvitamin D 3; Adult; Alkaline Phosphatase; Anticonvulsants; Bone and Bones; Calcifediol; Calcium; Dihydroxycholecalciferols; Epilepsy; Ergocalciferols; Female; Humans; Male; Middle Aged; Osteomalacia; Phosphates

Thirty-one adult epileptic outpatients on chronic combined anticonvulsant therapy were investigated. Eleven patients took vitamin D2 supplementation 400-1200 IU/day as multivitamin tablets. Mean serum calcium and renal calcium excretion were reduced. Serum alkaline phosphatase and urinary hydroxyproline excretion were increased. Forearm bone mineral content was reduced. Serum concentrations of 25-hydroxyvitamin D (25-OHD), 24-25-dihydroxyvitamin D (24,25-(OH)2D) and 1,25-dihydroxyvitamin D (1,25-(OH)2D) were reduced (p less than 0.001). A positive correlation was found between the serum 25-OHD and 24,25-(OH)2D concentrations (p less than 0.05) with the highest levels in those receiving vitamin D2 supplementation (p less than 0.01). Serum 1,25-(OH)2D correlated positively with renal calcium excretion (r = 0.65, p less than 0.001) suggesting that the intestinal calcium absorption in epileptic patients depends on 1,25-(OH)2D levels.

Topics: 24,25-Dihydroxyvitamin D 3; Adult; Alkaline Phosphatase; Anticonvulsants; Calcifediol; Calcitriol; Calcium; Dihydroxycholecalciferols; Drug Therapy, Combination; Epilepsy; Ergocalciferols; Female; Humans; Hydroxycholecalciferols; Hydroxyproline; Male; Middle Aged

Topics: Adult; Anticonvulsants; Calcium; Cholecalciferol; Creatinine; Epilepsy; Ergocalciferols; Female; Humans; Male; Middle Aged; Time Factors

Quantitative morphometric analyses of iliac crest biopsies from 20 epileptic patients receiving chronic anticonvulsant therapy have been performed before and after 4-8 months of vitamin D2 treatment with 9 000 U per day. Biochemical quantities, including serum 25-hydroxycholecalciferol (25-HCC) and serum parathyroid hormone (iPTH), were measured. The anticonvulsant osteomalacia found in the initial bone biopsies was characterized by an increased amount of ummineralized bone, an increased bone resorption and, contrary to vitamin D deficiency, an increased bone mineralization and bone formation. Bone resorption and bone formation were probably equally increased since the amount of cancellous bone was normal. Except for a slight increase in osteoidcovered surfaces and osteoclastic resorption surfaces, the bone changes were normalized after vitamin D2 treatment, leading to a mean serum level of 25-HCC 2.4 times above normal. Serum iPTH was normal before and unchanged during D2 therapy. The urinary calcium excretion remained decreased. The investigation characterizes anticonvulsant osteomalacia as a specific bone disease different from that of vitamin D deects of vitamin D metabolites on receptor cells.

Topics: Adult; Anticonvulsants; Bone and Bones; Bone Resorption; Calcium; Epilepsy; Ergocalciferols; Female; Humans; Hydroxycholecalciferols; Male; Middle Aged; Osteomalacia; Parathyroid Hormone; Phosphorus; Time Factors

Topics: Bone and Bones; Epilepsy; Ergocalciferols; Humans; Hydroxycholecalciferols; Ileum; Osteomalacia; Parathyroid Hormone; Phenytoin

In 54 epileptic outpatients treated for at least one year with anticonvulsants the bone mineral content (B.M.C.), an estimate of total body calcium, and serum calcium were measured before and during treatment with three doses of cholecalciferol (vitamin D3; 200, 100, and 50 mu-g daily) and 25-hydroxycholecalciferol (25-OHD3; 40, 20, and 10 mu-g daily) for 12 weeks. The results, when compared with the effects of calciferol (vitamin D2; 200, 100, and 50 mu-g daily) in 40 epileptic outpatients, showed different actions in anticonvulsant osteomalacia of vitamin D2 on the one hand and vitamin D3 and 25-OHD3 on the other. In the patients who received vitamin D2 an increase in B.M.C. was found whereas serum calcium was unchanged. The patients who received vitamin D3 or 25-OHD3 showed an increase in serum calcium but unchanged values of B.M.C. The results suggest that liver enzyme induction cannot alone explain anticonvulsant osteomalacia.

Topics: Anticonvulsants; Bone and Bones; Calcium; Cholecalciferol; Enzyme Induction; Epilepsy; Ergocalciferols; Humans; Hydroxycholecalciferols; Liver; Minerals; Osteomalacia

Topics: Adult; Anticonvulsants; Epilepsy; Ergocalciferols; Female; Humans; Osteomalacia

A patient of 29 years is described with Noonan's syndrome and idiopathic hypoparathyroidism, who presented with epilepsy and myoclonus. Correction of the hypocalcaemia resulted in improvement of his myoclonus and psychiatric abnormalities. The embryological significance of the association is discussed.

Topics: Adult; Aluminum Hydroxide; Calcium; Depression; Electroencephalography; Epilepsy; Ergocalciferols; Fluorescein Angiography; Humans; Hypoparathyroidism; Intelligence; Male; Myoclonus; Radiography; Retinal Vessels; Skull; Spinal Canal; Turner Syndrome

Topics: Anticonvulsants; Asia; Bone Resorption; Calcium; Calcium, Dietary; Epilepsy; Ergocalciferols; Humans; Hydroxycholecalciferols; Hyperparathyroidism; Hypoparathyroidism; Kidney; Kidney Failure, Chronic; Osteomalacia; Pigmentation; Renal Dialysis; Rickets; Scotland; Ultraviolet Rays; Vitamin D

Topics: Adult; Alkaline Phosphatase; Bone and Bones; Calcium; Epilepsy; Ergocalciferols; Female; Humans; Male; Middle Aged; Minerals; Osteomalacia; Phenytoin; Time Factors

The investigation and treatment of osteomalacia are described in four patients with epilepsy treated with long-term anticonvulsant therapy. It is suggested that drug-mediated enzyme induction may be the mechanism responsible by causing a greatly increased inactivation of vitamin D in these patients.

Topics: Adolescent; Adult; Alkaline Phosphatase; Anticonvulsants; Biopsy; Calcium; Enzyme Induction; Epilepsy; Ergocalciferols; Female; Humans; Male; Middle Aged; Osteomalacia; Phenytoin; Phosphorus; Primidone; Vitamin D

Topics: Adenocarcinoma; Adult; Calcium; Electrocardiography; Electroencephalography; Epilepsy; Ergocalciferols; Humans; Hypocalcemia; Hypoparathyroidism; Lung Neoplasms; Male

Topics: Diagnosis; Electroencephalography; Epilepsy; Ergocalciferols; Humans; Hypocalcemia

Topics: Brain; Brain Diseases; Calcification, Physiologic; Carbon Monoxide Poisoning; Disease; Epilepsy; Epilepsy, Generalized; Ergocalciferols; Parathyroid Diseases; Parathyroid Glands; Seizures; Vitamin D