Abstracts

Osteoporosis (OP) is a well-documented chronic adverse effect of AED therapy. DEXA scans are the standard testing procedure for OP. However, DEXA can be costly and exposes a patient to radiation. Heel ultrasound (HU) is less costly, can be performed during a routine office visit, and is less risky. HU is used in many screening programs for OP, but has not been evaluated as a tool to screen for OP due to AED therapy. Patients ages 19-70 yrs with epilesy and managed in our clinc are eligible for this study. Inclusion criteria are patients receiving PB, PHT, CBZ, or VPA for at least 6 months. Patients are excluded if they are pregnant, on chronic corticosteroid therapy, taking prescription medications for OP, have parathyroid disorders, are institutionalized, or have sores or abrasions on feet. A questionnaire is completed by the patient to asses OP risk factors and calcium intake. HU is performed in clinic using a Sahara Hologic Sonometer. Each patient is sent for a DEXA scan. WHO standards for diagnosis of osteopenia and osteoporosis are used. The primary outcome is comparison of HU to DEXA results. Secondary outcomes are evaluation of various risk factors and calcium intake. Statistical analysis will be using a students t-test and Pearson[apos]s correlation coefficient with [alpha]=0.05. A power analysis to detect at least a half standard deviation between HU and DEXA showed at least 64 individuals should be enrolled. A total of 65 participants will be enrolled. Preliminary evaluation of the first 7 patients enrolled in the study shows a mean age of 49.6 yrs, among 5 women and 2 men. Mean duration of older AED therapy was 12.4 yrs. 3 patients smoke an average of 1 ppd, 3 women had a hysterectomy, 2 patients have a fracture history, the mean caffeine intake is 2.4 cups of coffee/day, and 1 is taking hormonal replacement therapy. Four patients are osteopenic according to HU using WHO standards. Two patients have completed the study and the final diagnosis was consistent between HU and DEXA (1 osteopenic and 1 normal). A full comparison and evaluation of patients enrolled will be made. Very preliminary data show that HU may be a useful screening tool for OP in patients taking chronic AED.