Abstract
Children with cerebral palsy are recognised to be at risk of osteopenia but it's extent and aetiology are unclear. Nine children aged 2 to 13 years with cerebral palsy who were non-ambulant had measurements of bone mineral density of the lumbar spine. Assessments of 25 OH vitamin D status, parathyroid hormone activity and urinary calcium excretion were also performed.
All had evidence of severe osteopenia with bone mineral density standard deviation scores ranging from −1.7 to −4.2. Three, children had gross hypercalciuria. Parathyroid hormone activity was not increased. Although 25 OH vitamin D2 levels were universally low, all but one had adequate 25 OH vitamin D3 levels.
Three children with recurrent long bone fractures who have been treated over a 12 to 18 month period with bisphosphonate drugs have shown a marked increase in bone mineral density ranging from 16 to 40%. It appears that osteopenia in severe cerebral palsy is common but there is no consistent abnormality of vitamin D or parathyroid hormone status. Bisphosphonates may well be a useful therapeutic option in such children with recurrent fractures.
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Shaw, N., White, C., Fraser, W. et al. OSTEOPENIA IN CEREBRAL PALSY. Pediatr Res 33 (Suppl 5), S82 (1993). https://doi.org/10.1203/00006450-199305001-00471
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DOI: https://doi.org/10.1203/00006450-199305001-00471