Hypocalcemia and Osteomalacia Associated with Anticonvulsant Therapy

IT IS commonly known that hypocalcemia can cause a variety of epileptic seizure patterns. That anticonvul-sants used in the therapy of epilepsy can diminish the signs of tetany and tetanic equivalents in patients with hypocalcemia is less commonly recognized (1). Thus hypocalcemia may be overlooked as a cause of epilepsy if anticonvulsants are inadvertently administered for hy-pocalcemic convulsions. Recent reports from Europe now suggest that long-term anticonvulsant therapy may also initiate serum chemical and histologic changes of osteomalacia. These new observations can be logically accounted for by new findings in vitamin D metabolism. In 1968 Kruse reported that 15 % of epileptic pa-tients under treatment showed serum chemical and radiologic features of osteomalacia (2). The extent o