Search

The lay media and scientific literature have focused increasing attention on vitamin D deficiency and insufficiency in recent years. Low vitamin D levels confer increased an risk of abnormal bone mineralization, and are linked to poor bone health in epilepsy patients. However, vitamin D is not the only determinant of bone health in children with epilepsy. Anticonvulsant medications, in addition to features and comorbidities of epilepsy and coexisting neurologic diseases, are important factors in this complex topic. We review the basic metabolism of vitamin D in terms of bone health among children with epilepsy. We also discuss the literature regarding vitamin D and bone mineral density in this population. Finally, we suggest algorithms for screening and treating vitamin D insufficiency in these patients. [Copyright &y& Elsevier]

Background: To assess and compare resident and practicing child neurologists' attitudes regarding recruitment and residency training in child neurology.Methods: A joint task force of the American Academy of Pediatrics and the Child Neurology Society conducted an electronic survey of child neurology residents (n = 305), practicing child neurologists (n = 1290), and neurodevelopmental disabilities specialists (n = 30) in 2015. Descriptive and multivariate analyses were performed.Results: Response rates were 32% for residents (n = 97; 36% male; 65% Caucasian) and 40% for practitioners (n = 523; 63% male; 80% Caucasian; 30% lifetime certification). Regarding recruitment, 70% (n = 372) attributed difficulties recruiting medical students to insufficient early exposure. Although 68% (n = 364) reported that their medical school required a neurology clerkship, just 28% (n = 152) reported a child neurology component. Regarding residency curriculum, respondents supported increased training emphasis for genetics, neurodevelopmental disabilities, and multiple other subspecialty areas. Major changes in board certification requirements were supported, with 73% (n = 363) favoring reduced adult neurology training (strongest predictors: fewer years since medical school P = 0.003; and among practicing child neurologists, working more half-day clinics per week P = 0.005). Furthermore, 58% (n = 289) favored an option to reduce total training to 4 years, with 1 year of general pediatrics. Eighty-two percent (n = 448) would definitely or probably choose child neurology again.Conclusions: These findings provide support for recruitment efforts emphasizing early exposure of medical students to child neurology. Increased subspecialty exposure and an option for major changes in board certification requirements are favored by a significant number of respondents. [ABSTRACT FROM AUTHOR]