Comparison of Calcium Serum Concentration, Alkaline Phosphatase Serum and Bone Mineral Density Based on the Treatment Duration of Anti-epilepsy in Epilepsy Children

Objective: This research aimed to determine the difference between levels of serum calcium, alkaline phosphatase and bone mineral density based on the treatment duration of anti-epilepsy drugs in epilepsy children. Materials and methods: A cross sectional study was done in pediatric neurology outpatient department of Sanglah Hospital from May until July 2017. Forty-three samples were eligible in this study with the inclusion criteria being 1-11 years old epileptic patient, who were on first line of anti-epilepsy medicines (carbamazepine, phenobarbital, phenytoin, valproic acid) for 6 months or more regularly and agreed to join the research. Blood sample for calcium, ALP level and bone mineral density (BMD) were taken on each sample. Data was analysed by one way ANOVA for normal distribution variables and Kruskal-Wallis for abnormal distribution variables. Results: Bivariate analysis of one way ANOVA has revealed a significant difference of calcium levels based on duration of treatment (P=0.028). Post Hoc test showed the differences of the mean of calcium levels based on duration of treatment 0.28 (P=0.008; IK 95% 0.078-0.481). There were no significant difference of bone density (P=0.463) and serum ALP (P=0.087) based on duration of treatment. Conclusion: Long term antiepileptic treatment may reduce the serum calcium level significantly without inducing the severe hypocalcemia. Calcium and vitamin D supplementation should be considered for epileptic patient who are on long duration of treatment. Keywords: Alkaline phosphatase, Anti-epilepsy, Bone mineral density, Calcium, Children