Skip to main content

Advertisement

SpringerLink
Log in

Osteopenia in children with cerebral palsy can be treated with oral alendronate

  • Original Paper
  • Published:
Child's Nervous System Aims and scope Submit manuscript

A Correction to this article was published on 07 March 2023

This article has been updated

Abstract

Purpose

Cerebral palsy is one of the most common reasons of osteopenia in childhood. Patients have a significantly decreased bone mineral density, and painful fractures with minor traumas are common. Biphosphonates in the treatment of childhood osteoporosis are increasingly being used. This study aimed to evaluate the efficacy of oral alendronate treatment in children with cerebral palsy.

Methods

Twenty-six children (16 boys and 10 girls) aged 3 to 17 years who had quadriplegic cerebral palsy and osteopenia were included in the study. The patients received alendronate (1 mg/kg/week), calcium (600 mg/day), and vitamin D3 (400 U/day) over a year. A complete blood count, kidney and liver functional tests, plasma calcium, phosphate and alkaline phosphatase levels, and lumbar vertebral bone mineral density were measured before and after treatment.

Results

Compared with pretreatment values, bone mineral density, serum calcium, and phosphate levels of the patients statistically increased and alkaline phosphatase levels decreased after treatment. No patient needed to interrupt treatment because of side effects.

Conclusions

Oral alendronate at a dose of 1 mg/kg/week for the treatment of osteopenia in children with cerebral palsy was found to be safe and effective.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

Change history

References

  1. Akcay T, Turan S, Guran T, Bereket A (2008) Alendronate treatment in children with osteogenesis imperfecta. Indian Pediatr 45:105–109

    PubMed  Google Scholar 

  2. Ali O, Shim M, Fowler E, Greenberg M, Perkins D, Oppenheim W, Cohen P (2007) Growth hormone therapy improves bone mineral density in children with cerebral palsy: a preliminary pilot study. J Clin Endocrinol Metab 92:932–937

    Article  PubMed  CAS  Google Scholar 

  3. Allington N, Vivegnis D, Gerard P (2005) Cyclic administration of pamidronate to treat osteoporosis in children with cerebral palsy or a neuromuscular disorder: a clinical study. Acta Orthop Belg 71:91–97

    PubMed  Google Scholar 

  4. Baroncelli GI, Bertelloni S, Sodini F, Saggese G (2005) Osteoporosis in children and adolescents: etiology and management. Paediatr Drugs 7:295–323

    Article  PubMed  Google Scholar 

  5. Bass SL, Naughton G, Saxon L, Iuliano-Burns S, Daly R, Briganti EM, Hume C, Nowson C (2007) Exercise and calcium combined results in a greater osteogenic effect than either factor alone: a blinded randomized placebo-controlled trial in boys. J Bone Miner Res 22:458–464

    Article  PubMed  CAS  Google Scholar 

  6. Bianchi ML (2007) Osteoporosis in children and adolescents. Bone 41:486–495

    Article  PubMed  Google Scholar 

  7. Caulton JM, Ward KA, Alsop CW, Dunn G, Adams JE, Mughal MZ (2004) A randomised controlled trial of standing programme on bone mineral density in non-ambulant children with cerebral palsy. Arch Dis Child 89:131–135

    Article  PubMed  CAS  Google Scholar 

  8. Chad KE, Bailey DA, McKay HA, Zello GA, Snyder RE (1999) The effect of a weight-bearing physical activity program on bone mineral content and estimated volumetric density in children with spastic cerebral palsy. J Pediatr 135:115–117

    Article  PubMed  CAS  Google Scholar 

  9. Conwell LS, Chang AB (2009) Bisphosphonates for osteoporosis in people with cystic fibrosis. Cochrane Database Syst Rev (4):CD002010

  10. Demir E, Bereket A, Ozkan B, Topcu M (2000) Effect of alendronate treatment on the clinical picture and bone turnover markers in chronic idiopathic hyperphosphatasia. J Pediatr Endocrinol Metab 13:217–221

    Article  PubMed  CAS  Google Scholar 

  11. Glorieux FH, Bishop NJ, Plotkin H, Chabot G, Lanoue G, Travers R (1998) Cyclic administration of pamidronate in children with severe osteogenesis imperfecta. N Engl J Med 339(14):947–952

    Article  PubMed  CAS  Google Scholar 

  12. Goksen D, Darcan S, Coker M, Kose T (2006) Bone mineral density of healthy Turkish children and adolescents. J Clin Densitom 9:84–90

    Article  PubMed  Google Scholar 

  13. Henderson RC, Kairalla JA, Barrington JW, Abbas A, Stevenson RD (2005) Longitudinal changes in bone density in children and adolescents with moderate to severe cerebral palsy. J Pediatr 146:769–775

    Article  PubMed  Google Scholar 

  14. Henderson RC, Lark RK, Gurka MJ, Worley G, Fung EB, Conaway M, Stallings VA, Stevenson RD (2002) Bone density and metabolism in children and adolescents with moderate to severe cerebral palsy. Pediatrics 110(1 Pt 1):e5

    Article  PubMed  Google Scholar 

  15. Henderson RC, Lark RK, Kecskemethy HH, Miller F, Harcke HT, Bachrach SJ (2002) Bisphosphonates to treat osteopenia in children with quadriplegic cerebral palsy: a randomized, placebo-controlled clinical trial. J Pediatr 141:644–651

    Article  PubMed  CAS  Google Scholar 

  16. Houlihan CM, Stevenson RD (2009) Bone density in cerebral palsy. Phys Med Rehabil Clin N Am 20:493–508

    Article  PubMed  Google Scholar 

  17. Inoue Y, Shimojo N, Suzuki S, Arima T, Tomiita M, Minagawa M, Kohno Y (2008) Efficacy of intravenous alendronate for the treatment of glucocorticoid-induced osteoporosis in children with autoimmune diseases. Clin Rheumatol 27:909–912

    Article  PubMed  Google Scholar 

  18. Iwasaki T, Takei K, Nakamura S, Hosoda N, Yokota Y, Ishii M (2008) Secondary osteoporosis in long-term bedridden patients with cerebral palsy. Pediatr Int 50:269–275

    Article  PubMed  Google Scholar 

  19. Kilpinen-Loisa P, Nenonen H, Pihko H, Makitie O (2007) High-dose vitamin D supplementation in children with cerebral palsy or neuromuscular disorder. Neuropediatrics 38:167–172

    Article  PubMed  CAS  Google Scholar 

  20. Kitazaki S, Mitsuyama K, Masuda J, Harada K, Yamasaki H, Kuwaki K, Takedatsu H, Sugiyama G, Tsuruta O, Sata M (2009) Clinical trial: comparison of alendronate and alfacalcidol in glucocorticoid-associated osteoporosis in patients with ulcerative colitis. Aliment Pharmacol Ther 29:424–430

    Article  PubMed  CAS  Google Scholar 

  21. Lee JJ, Lyne ED (1990) Pathologic fractures in severely handicapped children and young adults. J Pediatr Orthop 10:497–500

    PubMed  CAS  Google Scholar 

  22. Noguera A, Ros JB, Pavia C, Alcover E, Valls C, Villaronga M, Gonzalez E (2003) Bisphosphonates, a new treatment for glucocorticoid-induced osteoporosis in children. J Pediatr Endocrinol Metab 16:529–536

    Article  PubMed  CAS  Google Scholar 

  23. Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B (1997) Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol 39:214–223

    Article  PubMed  CAS  Google Scholar 

  24. Phillipi CA, Remmington T, Steiner RD (2008) Bisphosphonate therapy for osteogenesis imperfecta. Cochrane Database Syst Rev (4):CD005088

  25. Plotkin H, Coughlin S, Kreikemeier R, Heldt K, Bruzoni M, Lerner G (2006) Low doses of pamidronate to treat osteopenia in children with severe cerebral palsy: a pilot study. Dev Med Child Neurol 48:709–712

    Article  PubMed  Google Scholar 

  26. Recker RR, Lewiecki EM, Miller PD, Reiffel J (2009) Safety of bisphosphonates in the treatment of osteoporosis. Am J Med 122(2 Suppl):22–32

    Article  Google Scholar 

  27. Salehpour S, Tavakkoli S (2010) Cyclic pamidronate therapy in children with osteogenesis imperfecta. J Pediatr Endocrinol Metab 23:73–80

    Article  PubMed  CAS  Google Scholar 

  28. Shaw NJ, White CP, Fraser WD, Rosenbloom L (1994) Osteopenia in cerebral palsy. Arch Dis Child 71:235–238

    Article  PubMed  CAS  Google Scholar 

  29. Sugiyama T, Takaki T, Saito T, Taguchi T (2007) Vitamin K therapy for cortical bone fragility caused by reduced mechanical loading in a child with hemiplegia. J Musculoskelet Neuronal Interact 7:219–223

    PubMed  CAS  Google Scholar 

  30. Tasdemir HA, Buyukavci M, Akcay F, Polat P, Yildiran A, Karakelleoglu C (2001) Bone mineral density in children with cerebral palsy. Pediatr Int 43:157–160

    Article  PubMed  CAS  Google Scholar 

  31. Unal E, Abaci A, Bober E, Buyukgebiz A (2006) Efficacy and safety of oral alendronate treatment in children and adolescents with osteoporosis. J Pediatr Endocrinol Metab 19:523–528

    PubMed  CAS  Google Scholar 

  32. Unay B, Sarici SU, Vurucu S, Inanc N, Akin R, Gokcay E (2003) Evaluation of bone mineral density in children with cerebral palsy. Turk J Pediatr 45:11–14

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Pediatrics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey

    Muhammet Sukru Paksu

  2. Department of Pediatric Neurology, Gulhane Military Medical Academy, Ankara, Turkey

    Sebahattin Vurucu, Bulent Unay & Ridvan Akin

  3. Department of Pediatrics, Gulhane Military Medical Academy, Ankara, Turkey

    Abdulbaki Karaoglu & Ahmet Polat

  4. Department of Nuclear Medicine, Gulhane Military Medical Academy, Ankara, Turkey

    Alper Ozgur Karacalioglu

  5. Department of Pharmacology, Gulhane Military Medical Academy, Ankara, Turkey

    Ozgur Yesilyurt

  6. Ondokuz Mayis Universitesi Tıp Fakultesi Cocuk Hastanesi, 55139, Samsun, Turkey

    Muhammet Sukru Paksu

Authors
  1. Muhammet Sukru Paksu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sebahattin Vurucu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Abdulbaki Karaoglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alper Ozgur Karacalioglu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ahmet Polat
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Ozgur Yesilyurt
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Bulent Unay
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Ridvan Akin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Muhammet Sukru Paksu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Paksu, M.S., Vurucu, S., Karaoglu, A. et al. Osteopenia in children with cerebral palsy can be treated with oral alendronate. Childs Nerv Syst 28, 283–286 (2012). https://doi.org/10.1007/s00381-011-1576-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00381-011-1576-9

Keywords

Search

Navigation