**7. Impaired bone health and seizures**

Long-term use of anti-seizure medications (ASM) has been linked in numerous studies to the development of osteoporosis, which affects between 11% and 31% of epilepsy patients and increases fracture risk by 2–6 times compared to the general population. The increased risk of fractures in epileptic patients can be attributed to a number of factors, such as fractures brought on by seizures and a higher chance of falling due to both the convulsions themselves and the adverse effect of ASM on balance [57–62]. There are other factors that contribute to the increased fracture risk in individuals with epilepsy, as evidenced by the fact that seizure-related fractures in people with epilepsy only make up 25–43% of all fractures. Comparing enzymeinducing ASM (EIASM) to non-enzyme-inducing ASM (NEIASM), previous research studies have demonstrated that EIASM has a deleterious impact on bone mass and the onset of osteoporosis. ASM polytherapy has additionally been linked to osteopenia [63–66].
