PT - JOURNAL ARTICLE AU - Baemisla Shiek Ahmad AU - Keith David Hill AU - Terence John O'Brien AU - Alexandra Gorelik AU - Natalie Habib AU - John Dennis Wark TI - Falls and fractures in patients chronically treated with antiepileptic drugs AID - 10.1212/WNL.0b013e31825f0466 DP - 2012 Jul 10 TA - Neurology PG - 145--151 VI - 79 IP - 2 4099 - http://n.neurology.org/content/79/2/145.short 4100 - http://n.neurology.org/content/79/2/145.full SO - Neurology2012 Jul 10; 79 AB - Objective: To evaluate fractures and falls in epilepsy patients taking antiepileptic drugs (AED) and to assess their awareness of AED-related bone health, falls, and fracture risk. Methods: A cross-sectional study was conducted in epilepsy patients taking AEDs and in nonepileptic non-AED users. Information on falls and fracture history was collected. Results: A total of 150 AED users were compared with 506 non-AED users. Users had greater odds of fracture at spine (odds ratio [OR] 3.92; confidence interval [CI] 1.08–14.16; p = 0.037), clavicle (OR 3.75; CI 1.24–11.34; p = 0.019), and ankle sites (OR 2.34; CI 1.01–5.42; p = 0.048), increased odds for osteoporosis (OR 4.62; CI 1.40–15.30; p = 0.012), and fracture occasions (OR 2.64; CI 1.29–5.43; p = 0.008). We estimate that with every year of AED use the odds of fractures increase by 4%–6%, or 40% per decade for any fracture (OR 1.40; CI 1.02–1.91) and 60% for seizure-related fractures (OR 1.63; CI 1.10–2.37). Non-seizure-related fractures (69% of cumulative fractures) occurred more than seizure-related fractures during therapy. Female users, compared to female nonusers, had more non-seizure falls (31% vs 17%, p = 0.027) and multiple falls (18% vs 5%, p = 0.028) in the preceding year. Fewer than 30% of epilepsy patients knew of the association of AED use with increased risk for fractures, decreased bone mineral density, or falls. Conclusions: Epilepsy patients taking AEDs had a higher risk of fractures, which was highest in those with longer-term AED exposure. Female AED users had a higher prevalence of falls than matched nonusers. Awareness among epilepsy patients regarding risks of falling and fractures was low. AED=antiepileptic drug; BMD=bone mineral density; CI=confidence interval; HREC=Human Research Ethics Committee; MWU=Mann–Whitney U; OR=odds ratio; RMH=Royal Melbourne Hospital; χ2=Chi-square test