Cerebral Palsy Osteoporosis,
 Osteopenia

Cerebral Palsy Osteoporosis and Osteopenia is one of the most common causes of low bone density among children.  What does science say?

"Bone density is significantly decreased, and children with CP often sustain painful fractures with minimal trauma that impair their function and quality of life. Preventing or improving osteoporosis and maximizing bone accrual during critical stages of growth will minimize the future lifelong risks of fractures in children with CP." Bone Density in Cerebral Palsy by Christine Murray Houlihan, MD and Richard D. Stevenson, MD. August 2009 Phys. Med Rehabili Cin N. America.

Diagnosis Of Cerebral Palsy Osteoporosis, Osteopenia in children

Parents should ask their child's physician for a dexa scan if their child has been diagnosed with CP. This recommendation is not new.

1. The July 2007 issue of Pediatr Radiology has an article by Larry A. Binkovitz and corresponding authors Paul Sparke and Maria J. Henwood that states in part: (abstract)

"Normal bone mineral accrual requires adequate dietary intake of calcium, vitamin D and other nutrients; hepatic and renal activation of vitamin D; normal hormone levels (thyroid, parathyroid, reproductive and growth hormones); and neuromuscular functioning with sufficient stress upon the skeleton to induce bone deposition. The presence of genetic or acquired diseases and the therapies that are used to treat them can also impact bone health. Since the introduction of clinical DXA in pediatrics in the early 1990s, there has been considerable investigation into the causes of low bone mineral density (BMD) in children. Pediatricians have also become aware of the role adequate bone mass accrual in childhood has in preventing osteoporotic fractures in late adulthood. Additionally, the availability of medications to improve BMD has increased with the development of bisphosphonates."

2. But even before that: In 1994 N J Shaw, C P White, W D Fraser, and L Rosenbloom published an article in Arch Dis Child about Cerebral Palsy Osteoporosis. Here is their abstract:

"The bone mineral density of the lumbar spine was assessed in nine non-ambulant children with cerebral palsy combined with measurements of serum 25-hydroxyvitamin D, parathyroid hormone, and urinary calcium excretion. Three children with recurrent fractures received treatment with bisphosphonates for periods ranging from 12-18 months. All the children demonstrated a severe reduction in bone mineral density even when allowance was made for their body weight. There were no consistent abnormalities of vitamin D or parathyroid hormone status. Three children had gross hypercalciuria. Each of the children treated with bisphosphonates demonstrated an increment in bone density " Note: hypercalciuria denotes an excess of calcium excreted in the urine.

To read the complete articles click on Cerebral palsy Osteoporosis

Final thoughts

Parents and care givers should raise this issue with their child's health care provider and ask if there are ways to improve weight bearing exercise in their children as early and as often as possible.

Additional ideas for incresing bone density, even in children, can be found at: Natural bone building