A rare but typical complication of anti-convulsant therapy: osteomalacia

A 63-year-old woman was admitted to the hospital with severe bone pain afte r about 30 years of anticonvulsant therapy with Primidone. She underwent an exhaustive examination for all possible causes of bone and back pain inclu ding colonoscopy, bronchoscopy and magnetic resonance tomography for the sp inal cord before the real nature of her problem was detected. All she neede d was a tiny tablet of Vitamin D daily and her chronic pain vanished within a few weeks. Vitamin D deficiency and consecutive osteomalacia as a compli cation of anticonvulsant therapy is well known since it has been described for the first time 1967. This easily treatable sideffect of a medication fo r which there are about 5 million proscriptions per year in Germany is rare ly seen and therefor easily overlooked.