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Despite being a subject of controversy, the majority of research suggests that decreased vitamin D levels correlate with increased bone turnover, that is, an important risk factor for osteoporosis development. In most guidelines, daily vitamin D supplementation is recommended. In persons with epilepsy (PWE), the situation is more complex, as other factors can increase the chance of being vitamin D deficient. Currently, there are no internationally accepted guidelines regarding monitoring bone health in PWE. Our aim was to review the existing evidence in PWE on: (1) risk factors for vitamin D deficiency, (2) the identification of higher risk groups, and (3) the optimal ways to monitor bone health. Our narrative review shows that: (1) anti\u2010seizure medication (ASM) use, especially enzyme\u2010inducing ASM (EIASM) and valproic acid, is identified as an important risk factor for impaired bone health (e.g., increased risk for osteoporosis\/fractures and\/or vitamin D deficiency); (2) higher risk groups within the PWE population are present: intellectual or physical disability, institutionalized patients, puberty, early onset epilepsy and developmental epileptic encephalopathies, postmenopausal women, and use of multiple ASM\/concomitant drugs (e.g. corticosteroids); and (3) a monitoring scheme can be suggested including laboratory tests, bone density measurements, managing of risk factors, and\/or vitamin D supplementation. Overall, regular vitamin D measurement in PWE is a cost\u2010effective and practical method for monitoring vitamin D deficiency, whereas in high\u2010risk patients the combination of vitamin D measurement and bone densitometry is recommended. There is not enough evidence to advocate continuous vitamin D supplementation in all PWE. Children with epilepsy should receive the recommended daily intake of vitamin D for age and additional monitoring and supplementation if at higher risk of deficiency. There is a need for prospective trials exploring the potential benefit of vitamin D supplementation in PWE.<\/jats:p>","DOI":"10.1111\/epi.18046","type":"journal-article","created":{"date-parts":[[2024,6,22]],"date-time":"2024-06-22T09:58:00Z","timestamp":1719050280000},"page":"2567-2579","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Vitamin D prophylaxis in persons with epilepsy?"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5319-6495","authenticated-orcid":false,"given":"Jo","family":"Sourbron","sequence":"first","affiliation":[{"name":"Department of Development and Regeneration, Section Pediatric Neurology University Hospital KU Leuven  Leuven 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