Asunto(s)
Infarto Cerebral/diagnóstico por imagen , Infecciones por Coronavirus/diagnóstico por imagen , Globo Pálido/diagnóstico por imagen , Hipoxia/diagnóstico , Neumonía Viral/diagnóstico por imagen , Betacoronavirus , COVID-19 , Infarto Cerebral/complicaciones , Infarto Cerebral/metabolismo , Infarto Cerebral/fisiopatología , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/metabolismo , Infecciones por Coronavirus/fisiopatología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/metabolismo , Cetoacidosis Diabética/complicaciones , Cetoacidosis Diabética/metabolismo , Diagnóstico Diferencial , Femenino , Humanos , Coma Hiperglucémico Hiperosmolar no Cetósico/complicaciones , Coma Hiperglucémico Hiperosmolar no Cetósico/metabolismo , Hipertensión/complicaciones , Hipertensión/fisiopatología , Hipoxia/complicaciones , Hipoxia/metabolismo , Hipoxia-Isquemia Encefálica/diagnóstico , Leucoencefalitis Hemorrágica Aguda/diagnóstico , Pulmón/diagnóstico por imagen , Imagen por Resonancia Magnética , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/metabolismo , Neumonía Viral/fisiopatología , Insuficiencia Respiratoria/complicaciones , Insuficiencia Respiratoria/metabolismo , Insuficiencia Respiratoria/fisiopatología , SARS-CoV-2 , Choque/complicaciones , Choque/metabolismo , Choque/fisiopatología , Vena Subclavia/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Trombosis de la Vena/complicaciones , Trombosis de la Vena/diagnóstico por imagenRESUMEN
BACKGROUND: Reduced bone mineral density (BMD) is increasingly recognized in patients receiving antiepileptic drug therapy. The precise prevalence is not known due to variability across populations studied. We set out to characterize the prevalence of abnormal BMD in an urban population of patients with epilepsy with the intent to determine the value of routine BMD screening. METHODS: We performed a cross-sectional study of 130 consecutive patients seen thorough our Comprehensive Epilepsy Center. BMD was measured using dual X-ray absorptiometry and was reported as T-score and Z-score. Additional information collected for each patient included age, race, gender, current and prior AEDs, ambulatory state, menopausal state, concomitant medications potentially associated with reduced bone mineralization, and comorbid illness potentially associated with reduced bone mineralization. Associations between reduced bone mineralization and variables were tested for significance using Fisher's exact test, Student's t-test, and Wilcoxon rank sum test. RESULTS: The average age of the entire study population was 43.5 (+/-12.5) years. Fifty-five percent of patients had T-score less than or equal to -1, the WHO criterion for osteopenia in postmenopausal women. The prevalence of Z-scores less than -2.0 was 15%, which is more than sixfold greater than expected. The markers for decreased BMD included older age or menopause in women, longer duration of therapy, and a history of use of phenytoin or phenobarbital. Assisted ambulation was also associated with low BMD. CONCLUSION: Our results indicate that reduced bone mineralization is prevalent and a significant health concern in an urban population of patients with epilepsy. Because of the high prevalence of reduced bone mineralization reported in numerous studies including this study, routinely screening for reduced bone mineralization is warranted in patients receiving anticonvulsant therapy.