Bone Status in Nonambulant, Epileptic, Institutionalized Youth: Improvement with Vitamin D Therapy

This study was conducted to determine if the adverse effects of anticonvulsant drug therapy and nonambulancy on bone status could be overcome with vitamin D therapy in severely handicapped individuals. Six male and five female gastrostomy fed, nonambulant, epileptic, profoundly mentally retarded individuals ranging in age from 7 to 17 years were given vitamin D therapy at a dosage of 4,000 IU/m² body surface area/day for 6 months. Photon absorptiometry and biochemical indices of bone status were measured to follow the effects of therapy. Bone mineral content expressed as a percentage of normal improved by 11 percent (p < 0.01), from 59.6 to 66.1 percent. Tartrate-resistant acid phosphatase, total alkaline phosphatase, and the bone isoenzyme activities declined 11 percent, 18 percent, and 11 percent respectively. These reductions were not statistically significant but they were consistent with the improvements observed by photon absorptiometry. The results of our study suggest that a conservative supplement of vitamin D will improve the bone status of severely disabled youths.