A case report on anti-epileptic drugs associated cerebral palsy and rickets


  • Sunil K. Behera Department of Doctor of Pharmacy, CMR College of Pharmacy, Kandlakoya, Medchal, Telangana, India
  • Divya Amaravadi Department of Pharm. D, CMR College of Pharmacy, Kandlakoya, Hyderabad, Telangana, India
  • Gurnoor Suman Department of Doctor of Pharmacy, CMR College of Pharmacy, Kandlakoya, Medchal, Telangana, India
  • N. Shri Hala Department of Doctor of Pharmacy, CMR College of Pharmacy, Kandlakoya, Medchal, Telangana, India
  • Arvini Shreya Department of General Medicine, Gandhi Hospital, Telangana, India




AEDs, Vitamin D, Cerebral palsy, Rickets, Seizures


Seizures are incredibly widespread all around the world, today. A seizure is often described as a transient alteration in the electrical activity of the brain. This required the treatment with antiepileptic drugs (AEDs). The majority of AEDs lower vitamin D levels. Vitamin D is found to be crucial for intestinal absorption of calcium, magnesium, and phosphate which helps to build and mineralize bones. Vitamin D deficiency has been seen to be a causative reason for cerebral palsy which is a neurological illness that affects movement and muscle coordination, permanently. It has been observed to manifest in infancy or early childhood due to vitamin D deficiency due to long term use of AEDs making it severe due to malnourishment. This case reports the use of antiepileptic drugs leading to cerebral palsy due to vitamin D deficiency. Therefore, by this case report we want to alert the readers and healthcare professionals about the possible adverse effects of AEDs and to be aware of them.


Vakili R, Eshraghi P, Nakhaei AA, Vakili S, Khakshour A, Saeidi M, et al. Congential rickets: reports of four cases. Int J Pediatrics. 2014;2(1):101-5.

Leanne M, Ward MD, Gaboury I. Vitamin D deficiency rickets among children in Canada. Canad Med Assoc. 2007;177(2):161-2.

Kija E, Gidal BE, Shapson-Coe A, Cader S, van der Watt G, Delport S, Wilmshurst JM. Vitamin D abnormalities and bone turn over analysis in children with Epilepsy in the Western Cape of South Africa. Seizure. 2019;73:84.

Heshmat R, Mohammad K, Majdzadeh S, Forouzanfar M, Bahrami A, Ranjbar Omrani G, et al. Vitamin D Deficiency in Iran: A Multi-center Study among Different Urban Areas. Iran J Public Health. 2021;37(2):72-8.

Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. A report: the definition and classification of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007;109:8-14.

Peterson MD, Haapala HJ, Chaddha A, Hurvitz EA. Abdominal obesity is an independent predictor of serum 25-hydroxy vitamin D deficiency in adults with cerebral palsy. Nutr Metab (Lond). 2014;11:22.

Friedman MJ, Sharieff GQ. Seizures in children. Pediatr Clin N Am. 2006;53(2):257-77.

Seth A, Aneja S, Singh R, Majumdar R, Sharma N, Gopinath M. Effect of impaired ambulation and anti-epileptic drug intake on vitamin D status of children with cerebral palsy. Paediatr Int Child Health. 2017;37:193-8.

Nettekoven S, Ströhle A, Trunz B, Wolters M, Hoffmann S, Horn R, et al. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy. Eur J Pediatr. 2008;167(12):1369-77.

Misra M, Pacaud D, Petryk A, Collett-Solberg PF, Kappy M; Drug and Therapeutics Committee of the Lawson Wilkins Pediatric Endocrine Society. Vitamin D deficiency in children and its management: review of current knowledge and recommendations. Pediatrics. 2008;122(2):398-417.

Xu Z, Jing X, Li G, Sun J, Guo H, Hu Y, et al. Valproate decreases vitamin D levels in pediatric patients with epilepsy. Seizure. 2019;71:60-5.

Manohar S, Gangadaran RP. Vitamin D status in children with cerebral palsy. Int J Contemp Pediatr. 2017;4(2):615-9.






Case Reports