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Overview Epileptic children and Vitamin D


Fact: Anti-epilepsy drugs lower vitamin D levels
Fact: Epilepsy 5X more likely if preterm birth (low vitamin D)
Fact: Preterm greatly decreased if add vitamin D and/or Omega-3
Fact: Vitamin D supplementation increases Vitamin D levels
Recommendation: Epileptics should take vitamin D to:
    Reduce the number of seizures (restore vitamin D then take a maintenance dose of at least 5,000 IU daily)
   Avoid having health problems associated with low vitamin D, such as low bone density
1 study: Epileptics have low vitamin D levels before starting treatment
Epilepsy = 4,000 years of ignorance, superstition and stigma
   followed by 100 years of knowledge, superstition and stigma.

Table of contents

17 items in Epilepsy category

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Epilepsy seizures reduced by daily 1,000 IU of Vitamin D (added to monotherapy) - RCT Sept 2024

Vitamin D Supplementation for Children with Epilepsy on Antiseizure Medications: A Randomized Controlled Trial
Children 2024, 11(10), 1187; https://doi.org/10.3390/children11101187
by Fahad A. Bashiri 1,2,*,†ORCID,Abrar Hudairi 1,2ORCID,Muddathir H. Hamad 1,2,Lujain K. Al-Sulimani 3,Doua Al Homyani 3,Dimah Al

Background: Antiseizure medications (ASMs) are crucial for managing epilepsy in children. However, a well-documented side effect of ASMs is their impact on bone health, often due to interference with vitamin D metabolism. This can lead to vitamin D deficiency in children with epilepsy. This study aimed to determine if a daily dose of 400 IU or 1000 IU would maintain adequate vitamin D levels in children with epilepsy.

Methods: A phase IV randomized controlled trial enrolled children aged 2–16 years with epilepsy and receiving antiseizure medications. Children were divided into two groups: the monotherapy group, which was defined as children on one antiseizure medication (ASM), and the polytherapy group, which was defined as children receiving two or more ASMs. Eligible children with levels above 75 nmol/L were randomized to receive a maintenance dose of either 400 IU/day or 1000 IU/day of cholecalciferol. Baseline and 6-month assessments included demographic data, anthropometric measurements, seizure type, medications, seizure control, and 25(OH)D level.

Results: Out of 163 children, 90 were on monotherapy and 25 on polytherapy. After 6 months of vitamin D maintenance, the proportion of children with 25(OH)D concentration below 75 nmol/L was 75.0% in the 400 IU group and 54.8% in the 1000 IU group. In the monotherapy group, baseline seizure-free children increased from 69% to 83.6% after treating vitamin D deficiency.

Conclusion: Daily vitamin D supplementation with 1000 IU may be beneficial for children with epilepsy, particularly those receiving monotherapy, to maintain sufficiency and potentially improve seizure control.
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Poor vitamin D genes can result in juvenile absence epilepsy - May 2023

The causal effect of serum 25-hydroxyvitamin D levels on epilepsy: A two-sample Mendelian randomization study
Epilepsia Open . 2023 May 9. doi: 10.1002/epi4.12758 PDF is behind a paywall
Xinxin Luo, Zhichao Ruan 1, Ling Liu 2

Objective: Observational studies have shown an association between 25-hydroxyvitamin D (25(OH)D) and epilepsy, but it is unclear whether the association is causal. Therefore, we applied Mendelian randomization (MR) analysis to determine the causal relationship between serum 25(OH)D levels and epilepsy.

Methods: We conducted a two-sample Mendelian randomization (TSMR) study to investigate the association between serum 25(OH)D levels and epilepsy using pooled statistics from genome-wide association studies (GWAS). Data for 25(OH)D came from a GWAS comprising 417,580 participants, and data for epilepsy were obtained from the International League Against Epilepsy (ILAE) consortium. Five methods were used to analyze TSMR, including the inverse variance weighting method, MR Egger method, weighted median method, simple model, and weighted model. In the sensitivity analysis, MR Egger and MR PRESSO methods were used to test for pleiotropy, inverse variance weighting and MR Egger in Cochran's Q statistics were used to test for heterogeneity.

Results: MR analyzed the relationship between 25(OH)D and different types of epilepsy, and the results showed that a 1 standard deviation increase in natural log-transformed serum 25(OH)D levels was associated with reduced risk for juvenile absence epilepsy (IVW OR = 0.985; 95% confidence interval (CI): 0.971-0.999; P-value = 0.038). There was no apparent heterogeneity and horizontal gene pleiotropy.

Significance: Higher serum levels of 25(OH)D were a protective factor for adolescent absence epilepsy, but had no effect on other types of epilepsy.
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From the web: "Juvenile absence epilepsy (JAE) is a type of epilepsy that causes absence (“ab-SONCE”) seizures. During a seizure, the child will stare and stop what they are doing. They may blink quickly or move their hands. They may look like they are daydreaming or not paying attention. These seizures last only a few seconds."
JAE accounts for 1 to 2% of childhood epilepsies .

Antiseizure Medications reduce vitamin D genes, need new guidelines – Feb 2023

Vitamin D Supplementation in Children on Antiseizure Medications: High Time to Have Proper Guidelines
Indian Journal of Pediatrics
Kaushik Ragunathan & Biswaroop Chakrabarty

A recent meta-analysis highlighted significantly reduced serum vitamin D levels in epileptic children receiving valproate monotherapy compared to healthy controls. Although it is not a conventional hepatic enzyme inducer, there are reports of valproate inducing CYP3A4 and CYP24A1, both involved in vitamin D catabolism [1]. Valproate activates pregnane X receptor which regulates the expression of vitamin D responsive genes [2]. Apart from its importance in bone growth and development, vitamin D also plays a significant role in the functioning of muscular, immune, and cardiovascular systems [1].
Studies by Viraraghavan et al. and Mikati et al. have shown the utility of vitamin D supplementation in children on antiseizure medications (ASMs) [3, 4]. The present study by Mishra et al. is a welcome addition in that direction, evaluating the utility of vitamin D supplementation in children on valproate monotherapy [5].
Mishra et al. studied children aged 2–12 y with new onset epilepsy on valproate monotherapy with vitamin D–sufficient status at baseline. They were randomized into 2 arms: intervention arm receiving vitamin D (600 IU/d) for a period of 90 d and a control group receiving only ASM. The median vitamin D level significantly increased and decreased, respectively, in the intervention and control arms over 3 mo [5].
Mikati et al. and Viraraghavan et al. included cases of a variety of ASMs as mono- or polytherapy. Although Viraraghavan included new-onset epilepsy cases, subjects in the study by Mikati et al. were on ASM for at least 6 mo. Viraraghavan et al. prescribed 60,000 IU/mo of vitamin D in the intervention arm, whereas Mikati et al. had two arms, one receiving 400 IU/d and another receiving 2000 IU/d of vitamin D. Contrary to the study by Mishra et al., both of these studies included cases of vitamin D deficiency at baseline [3, 4]. Viraraghavan et al. demonstrated maintained serum vitamin D levels at 6-mo follow-up in the intervention arm compared to a significant decrease in the control arm [3]. Mikati et al. found a significant increase in both intervention groups at 1-y follow-up; however, the values were comparable in both groups. They also documented increases in bone mineral density at multiple skeletal sites in both arms [4]. The study by Mishra et al. reinforces the fact that even children with vitamin D–sufficient status show a significant fall in serum levels on ASM therapy that can be prevented by vitamin D supplementation.
The Endocrine Society recommends at least 2–3 times the RDA of vitamin D on ASM polytherapy [6]. Recent literature has unveiled possible anticonvulsant effects of vitamin D mediated by reduction in voltage-sensitive calcium channel expression, inhibition of iNOS, and suppression of inflammatory cytokines [7]. Mishra et al. did not show any difference in breakthrough seizures between the control and intervention arms; however, the follow-up is only for 90 d [5].
Thus, the current study further reiterates the utility of vitamin D supplementation in children with epilepsy and paves the way for future studies on various ASM mono- and polytherapies, including the long-term effect of vitamin D on seizure control.
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Epilepsy 5.4 X more likely if premature birth (assocated with low vitamin D) - Sept 2021

Hypovitaminosis D and risk factors in pediatric epilepsy children
BMC Pediatrics Vol 21, # 432 (2021) https://doi.org/10.1186/s12887-021-02906-7
Napakjira Likasitthananon, Charcrin Nabangchang, Thitiwan Simasathien, Suchavadee Vichutavate, Voraluck Phatarakijnirund & Piradee Suwanpakdee

Background
Anti-seizure medication (ASM) treatment is one of the significant risk factors associated with abnormal vitamin D status in epilepsy patients. Multiple studies have shown that adult epilepsy patients can exhibit vitamin D deficiency. However, there are few reports investigating pediatric epilepsy patients. In this study, we aimed to identify risk factors related to hypovitaminosis D in pediatric epilepsy patients in Thailand.

Methods
A cross-sectional retrospective cohort study was conducted in 138 pediatric epilepsy patients who received anticonvulsants from April 2018 to January 2019. Demographic data, seizure types, puberty status, physical activity, duration, and types of anti-seizure medications were analyzed. Patients with abnormal liver function, abnormal renal function, and who received vitamin D supplements or ketogenic diet containing vitamin D were excluded. Levels of serum vitamin D (25(OH)D) were measured.

Results
All 138 subjects were enrolled, the age ranged from 1.04 – 19.96 years; (mean = 9.65 ± 5.09), the mean serum 25(OH) D level was 26.56 ± 9.67 ng/ml. The prevalence of vitamin D deficiency was 23.2% and insufficiency was 47.8% respectively. Two risk factors—puberty status (OR 5.43, 95% CI 1.879-15.67) and non-enzyme-inhibiting ASMs therapy (OR 3.58, 95% CI 1.117-11.46)—were significantly associated with hypovitaminosis D, as shown by multivariate analyses.

Conclusions
Our study reports the high prevalence of hypovitaminosis D in pediatric epilepsy patients in Thailand despite being located in the tropical zone. These findings can guide clinicians to measure vitamin D status in pediatric epilepsy patients particularly when they reach puberty and/or are using non-enzyme-inhibiting ASMs therapy. Early detection of vitamin D status and prompt vitamin D supplementation can prevent fractures and osteoporosis later in life.
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101+ VitaminDWiki pages with PRE-TERM etc in title

This list is automatically updated

Items found: 104
Title Modified
Vitamin D and pregnancy, preterm birth, preeclampsia - Whittle Nov 2024 24 Nov, 2024
Preterm birth decreased by Omega-3, etc. - many studies 01 Oct, 2024
Preterm births appear reduced 34% by Vitamin D, 11% by Omega-3 - Jan 2021 01 Oct, 2024
Preterm births reduced by Vitamin D - many studies 01 Oct, 2024
Pfizer’s RSV vaccine found to increase risk of preterm births by 24%, etc. – Sept 2024 29 Sep, 2024
Very preterm infants with low vitamin D are 4 X more likely to have retinal problems – Aug 2024 19 Aug, 2024
Omega-3 fatty acid in pregnancy reduces risk of preterm and early preterm birth – Feb 2024 17 Aug, 2024
800 mg of Magnesium early in 3rd trimester significantly increased brain activity in preterm infants – RCT May 2024 03 Jun, 2024
Preterm birth rate increased in US but decreased in Finland (high Vitamin D) - Jan 2024 09 Feb, 2024
Off Topic: Xylitol reduces cavities, preterm births, osteoporosis, RTI, obesity, diabetes, etc. - several studies 01 Jan, 2024
Preterm birth chance reduced –17P (expensive drug) or Vitamin D – June 2015 01 Jan, 2024
Preterm birth and low Vitamin D - many studies 24 Dec, 2023
Preterm births are VERY costly – Feb 2017 24 Dec, 2023
Preterm birth cost for employers approximately 50,000 dollars – Oct 2017 24 Dec, 2023
Preterm Birth 2.7X more likely if low vitamin D (dark skin in this case) - Nov 2023 01 Nov, 2023
4.4 X more likely to have a preterm birth if low vitamin D while pregnant (India) - May 2022 01 Nov, 2023
Omega-3 supplementation reduced preterm birth rate by 4X – RCT July 2020 21 Oct, 2022
Arab preterm infants often have less than 10 ng of vitamin D - 2010 15 May, 2022
Preterm birth interventions – 4 studies found possible vitamin D benefit – Cochrane – Nov 2018 15 May, 2022
Preterm birth might be prevented by Vitamin D, Omega-3, etc. (International survey) – Jan 2019 15 May, 2022
Preterm Births - promising preventions – anti-oxidants, Vitamin D, Omega-3, Zinc, etc. – Jan 2019 15 May, 2022
Preterm birth reduction by nutrients - Vitamin D is the best, Omega-3 is next best – May 2022 15 May, 2022
Preterm birth rate of pregnant smokers cut in half if take Omega-3 – RCT May 2017 20 Feb, 2022
Preterm birth varies with season: 25 percent more likely if conception in autumn – Feb 2022 04 Feb, 2022
Supplement preterm infants with vitamin D if less than 80 ng – RCT Sept 2021 28 Sep, 2021
Pre-term birth rate cut in half with 1000 milligrams of Omega-3 (if initially low) – RCT May 2021 04 Jun, 2021
Preterm birth risk increased 16 pcnt if heat wave (perhaps outside less) - Nov 2020 16 Nov, 2020
Preterm birth associated with many genes, including the Vitamin D Receptor again – Jan 2020 30 Jan, 2020
Preterm birth 8X more likely if poor Vitamin D Receptor – Dec 2019 31 Dec, 2019
8 percent fewer preterm births if adequate Selenium from food – Aug 2019 24 Dec, 2019
Pregnant women in Australia to take Omega-3 when told of reduction in preterm births – Dec 2019 19 Nov, 2019
Preterm birth 9 X more likely if fetus had a poor Vitamin D Receptor and previous miscarriage – Aug 2017 12 Nov, 2019
Preterm births reduced by Vitamin D, Omega-3, Zinc – Oct 2019 26 Oct, 2019
Preterm birth rate not vary with vitamin D level (when all are less than 30 ng) – Oct 2019 17 Oct, 2019
Extreme preterm infants helped somewhat by 800 IU of vitamin D – RCT Jan 2018 01 Oct, 2019
Preterm Births reduced by Omega-3, Zinc, and Vitamin D – Aug 2019 09 Aug, 2019
Preterm birth increases risk of heart disease by 1.5 X by age 40 – June 2019 06 Aug, 2019
Preterm Births decreased by Omega-3 (analysis of 184 countries) – April 2019 27 Apr, 2019
Vaginal microbiome varies with race, vitamin D level, preterm birth, etc. - March 2019 27 Mar, 2019
Preterm birth 3X more likely if low vitamin D – Oct 2018 07 Feb, 2019
Omega-3 index of 5 greatly decreases the risk of an early preterm birth – Dec 2018 04 Jan, 2019
Preterm babies have low vitamin D, but recover in 6 weeks with 800 IU supplementation – Jan 2019 01 Jan, 2019
Preterm births 12 X more likely if poor Vitamin D Receptor (white infants in Italy) – meta-analysis Aug 2018 27 Aug, 2018
Autism and ADHD type disorders were 14X more likely in survey of extreme preterm vaccinated infants - April 2017 04 Jul, 2018
FDA petitioned to acknowledge that vitamin D cuts preterm birth rate in half – May 2018 13 May, 2018
Preterm birth 4X more likely if Vitamin D deficient – Feb 2018 04 Apr, 2018
Third trimester Vitamin D levels were lower if pre-term labor was expected – March 2018 24 Mar, 2018
Preterm birth 4X more likely if very low Vitamin D (Chinese) - Feb 2018 28 Feb, 2018
Pregnancies with more than 40 ng of vitamin D are great - miscarriage, LBW, SGA, preterm – Feb 2018 14 Feb, 2018
Pregnancies with more than 40 ng of vitamin D are great - miscarriage, LBW, SGA, preterm – Feb 2018 14 Feb, 2018
Preterm birth rates increased in 15 European countries – Oct 2013 23 Dec, 2017
Increasing Omega-3 reduces heart problems, autism, depression, preterm birth, breast cancer, etc. 15 Dec, 2017
Vitamin D intervention reduces preterm births and low birth weight by 60 percent – Cochrane Reviews – Nov 2017 07 Dec, 2017
Preterm birth rate increased 60 percent in 50 years (US) 26 Nov, 2017
Preterm cost for employers, increased 65 percent in 2 years – Oct 2017 26 Nov, 2017
Preterm birth far more likely if previous miscarriage and poor Vitamin D receptor – Aug 2017 20 Nov, 2017
Preterm birth is related to Vitamin D Receptor problems – many studies agree 13 Nov, 2017
Preterm births strongly related to Vitamin D, Vitamin D Receptor, Iodine, Omega-3, etc 13 Nov, 2017
Preterm birth and Vitamin D Receptor – Dec 2016 13 Nov, 2017
Vitamin D Receptor is associated with preeclampsia, gestational diabetes and preterm birth – Nov 2017 10 Nov, 2017
APS (associated with miscarriage, stillbirth. preterm delivery and stroke) is 3X more likely if low vitamin D – meta-analysis Oct 2017 13 Oct, 2017
Preterm birth trend toward 2.5 X more likely if less than 10 ng of Vitamin D – Aug 2017 26 Aug, 2017
Preterm birth rate reduced by vitamin D – 78 percent if non-white, 39 percent if white – July 2017 27 Jul, 2017
Preterm birth more likely if dark skinned and low vitamin D (not white-skinned) – April 2017 06 Jul, 2017
Dark skinned Canadian women with low vitamin D are 4 X more likely to have preterm births – April 2017 06 Jul, 2017
Preterm birth 2X more likely if poor Vitamin D Receptor, 9 X if also had previous miscarriage – June 2017 15 Jun, 2017
Sepsis in first year of life is much more likely if preterm (low Vitamin D) – May 2017 10 May, 2017
Iodine added during pregnancy reduces preterm births, increases IQ. Etc. 27 Apr, 2017
Risk of preterm birth twice as likely when less than 10 ng of vitamin D – Nov 2016 13 Apr, 2017
Preterm labor 20 times more likely if low vitamin D, etc. (India) – Feb 2017 08 Mar, 2017
Preterm birth rate reduced by 43 percent with adequate Vitamin D supplementation – meta-analysis Feb 2017 02 Mar, 2017
Preterm birth rate reduced by 0.57 with adequate Vitamin D supplementation – meta-analysis Feb 2017 28 Feb, 2017
Pre-term birth - many of risk factors are associated with low vitamin D 27 Feb, 2017
Preterm birth rate reduced 57 percent by Vitamin D – Nov 2015 23 Jan, 2017
Vitamin D Webinar - cost of pre-term birth etc- Baggerly Nov 2013 11 Dec, 2016
Preterm birth extended by 2 weeks with Omega-3 – Meta-analysis Nov 2015 10 Dec, 2016
Preterm birth 3.3 times more likely if Vitamin D Receptor gene problem – Aug 2016 15 Oct, 2016
Omega-3 supplementation during pregnancy reduce early preterm births (save 1500 USD per child) – Aug 2016 12 Oct, 2016
Zinc helps pregnancies – 14 percent fewer preterm births, etc. – Cochrane RCT Feb 2015 14 Jun, 2016
Preterm birth has become the leading cause of infant mortality (vitamin D not mentioned) – JAMA June 2016 07 Jun, 2016
Preterm birth 30 percent more likely if low vitamin D – meta-analysis May 2016 20 May, 2016
Extreme preterm infants need a total of 1,000 IU of vitamin D daily – RCT April 2016 13 Apr, 2016
Asthmatic pregnant women had 30 percent more preterm births if air pollution (vitamin D not mentioned) – March 2016 09 Mar, 2016
Omega-3 helps pregnancy in many ways: preterm 26 percent less likely etc – review July 2012 08 Sep, 2015
Extreme preterm survival 30 percent less likely if little sunshine 23-28 weeks – June 2015 05 Sep, 2015
Magnesium (Sulfate) reduces risk of cerebral palsy for those at risk of pre-term births – Dec 2013 18 Aug, 2015
Respiratory distress after preterm birth is more likely if low vitamin D – review April 2015 05 Aug, 2015
Pre-term births reduced in half if 40 ng of vitamin D in 3rd trimester – Nov 2014 15 Mar, 2015
Preterm births are associated most strongly with low vitamin D in third trimester – Nov 2014 13 Mar, 2015
Low Vitamin D – 2X more likely to have premie AND mother later to have heart problems – Feb 2015 12 Feb, 2015
Chance of preterm birth is strongly associated with low vitamin D – Feb 2015 05 Feb, 2015
The more preterm the birth, the lower the vitamin D level (both mothers and infants) – Feb 2014 05 Feb, 2015
Preterm infants more likely to have vitamin D levels below 20 ng – Feb 2014 05 Feb, 2015
Decreased risk of preterm birth if have more than 36 ng of vitamin D – Jan 2015 09 Jan, 2015
Autism associated with preterm and low birth weight (both associated with low vitamin D) – Nov 2014 31 Dec, 2014
Preterm infants, kidney, rickets and vitamin D intake: is it time for rewriting the history – Aug 2014 26 Aug, 2014
Fewer pre-term births after pollution reduction (vitamin D not mentioned) April 2014 16 Jun, 2014
300 IU is not enough vitamin D for preterm infants – March 2014 22 Apr, 2014
Pre-term birth 3X more likely and C-section 4X if less than 20 ng of vitamin D – May 2012 13 Feb, 2014
Recurrent pre term birth and low vitamin D – Dec 2012 23 Jan, 2013
Osteopenia in preterm infants – May 2012 27 Dec, 2012
Blacks have more pre-term births due to low nutrients such as vitamin D – Sept 2011 14 Sep, 2011
Pre-term birth not associated with first tri-mester vitamin D – April 2011 21 Apr, 2011
Dark-skin plus low vitamin D in first trimester made preterm birth 2.9 X more likely – Dec 2019 No value for 'modification_date_major'

Seizures associated with low vitamin D - June 2021

Micronutrient characteristic in recurrent seizure in medicinecontrolled epileptic children with normal nutritional status!!!Siezures associated with low vitamin D - June 2021
Acta Neurol Taiwan . 2021 Jun;30(2):54-62.
Irwanto Idris 1, Chasan Ismail 1, Muhammad Riski Darmawan Moestakim 1
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Image

Background: Recurrent seizure in epileptic children is correlated with future motoric disorders, behavior problems, and intellectual disabilities. Various factors are thought to modulate the risk of recurrent seizure, including micronutrient status such as calcium, 25-dehydroxycholecalciferol (25-(OH)D), and serum iron presented as hemoglobin level.

Aim: To analyze correlation between micronutrient characteristics of epileptic children and recurrence of seizure.

Methods: This cross-sectional retrospective study was conducted in the pediatric clinic of Dr. Soetomo hospital from September to October 2019. Epileptic children with long-term anti-epileptic drugs (AED) for over 6 months and ages ranging 2-18 years were included. Recurrent and non-recurrent group were compared. Age, family history of seizure, and duration of AED administration were noted. Peripheral serum level of hemoglobin, calcium, and 25-(OH)D was measured. The median 25-(OH) D level of both groups were corelated with recurrent seizure by using Spearman test (95% confidence interval).

Results: Thirty children were enrolled. Recurrent seizure was occurred in 19 children. There was significant correlation on hemoglobin and calcium, and 25-(OH)D level with the recurrence of seizure (p less then 0.05). Among all observed micronutrients, 25-(OH)D has the strongest correlation (r = 0.750). There was no significant correlation between recurrent seizure and both family history and AED administration duration.

Conclusion: Micronutrients status is correlated with prevalence of recurrent seizure. Level of 25-(OH)D is strongly correlated, whereas level of hemoglobin, and calcium have weak correlation with recurrent seizure in epileptic children.

Digestive problems with Epilepsy (perhaps need Gut-Friendly Vitamin D ) - Aug 2021

Functional Gastrointestinal Disorders in Patients With Epilepsy: Reciprocal Influence and Impact on Seizure Occurrence
Front. Neurol., 06 August 2021 Volume 12 - 2021 | https://doi.org/10.3389/fneur.2021.705126
Federica Avorio1,2†, Emanuele Cerulli Irelli1†, Alessandra Morano1, Martina Fanella1, Biagio Orlando1, Mariarita Albini3, Luca M. Basili1, Gabriele Ruffolo4, Jinane Fattouch1, Mario Manfredi1, Emilio Russo5, Pasquale Striano6, Marilia Carabotti7, Anna T. Giallonardo1, Carola Severi8 and Carlo Di Bonaventura1*

Introduction: The complex relationship between the microbiota-gut-brain axis (MGBA) and epilepsy has been increasingly investigated in preclinical studies. Conversely, evidence from clinical studies is still scarce. In recent years, the pivotal role of MGBA dysregulation in the pathophysiology of functional gastrointestinal disorders (FGID) has been recognized. With this background, we aimed to investigate the prevalence of FGID in patients with epilepsy (PWE) and the possible impact of bowel movement abnormalities on seizure recurrence.

Methods: A total of 120 PWE and 113 age-, sex-, and BMI-matched healthy subjects (HS) were consecutively enrolled. A questionnaire to evaluate the presence of FGID (according to Rome III diagnostic criteria) was administered to all participants. In a subgroup of drug-resistant patients, we administered an ad-hoc questionnaire combining Bristol stool charts and seizure diaries to evaluate seizure trends and bowel movement changes.

Results: A higher prevalence of FGID in PWE (62.5%) than in HS (39.8%) was found (p < 0.001). The most frequently observed disorder was constipation, which was significantly higher in PWE than in HS (43.3 vs. 21.2%, p < 0.001), and was not associated with anti-seizure medication intake according to multivariable analysis. In drug-resistant patients, most seizures occurred during periods of altered bowel movements, especially constipation. A significant weak negative correlation between the number of days with seizures and the number of days with normal bowel movements was observed (p = 0.04). According to multivariable logistic regression analysis, FGID was significantly associated with temporal lobe epilepsy as compared with other lobar localization (p = 0.03).

Conclusions: Our clinical findings shed new light on the complex relationship between epilepsy and the MGBA, suggesting a bidirectional link between bowel movement abnormalities and seizure occurrence. However, larger studies are required to better address this important topic.
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Review of Epilepsy trials with supplements- Nov 2020

. 2020 Oct 29;S0261-5614(20)30591-4. doi: 10.1016/j.clnu.2020.10.045
Clinical trials of vitamin-mineral supplementations in people with epilepsy: A systematic review
Ali A Asadi-Pooya 1, Leila Simani 2

Objective: The purpose of the current study was to systematically review the literature on the clinical trials of vitamin-mineral supplementations in people with epilepsy (PWE) to treat their seizures.

Methods: MEDLINE and Scopus from inception to August 25, 2020 were searched for related published manuscripts. The search keywords included "vitamin or folate or folic acid or biotin or thiamine or carnitine or zinc or manganese or selenium or omega-3 fatty acid or linoleic acid or micronutrient or trace element or supplementation" AND "epilepsy or seizure".

Results: We could identify 26 related articles. Seventeen studies provided class 2 of evidence and the rest provided class 3 of evidence. Eight studies investigated polyunsaturated fats, seven groups studied folic acid, four studies explored the effects of vitamin D, two investigated vitamin E, and three others studied multivitamin cocktails. There was one study on zinc and one on selenium. There is some evidence on the efficacy of polyunsaturated fats in treating seizures in PWE. The evidence on the efficacy of multivitamin cocktails in adults is promising.

Conclusion: High quality data on the efficacy of nutritional (vitamins-minerals) supplementations in treating seizures in PWE is scarce; however, designing future clinical trials of polyunsaturated fatty acid supplementation for drug-resistant seizures in adults with focal epilepsy and in children, and also multivitamin supplementations in adults with focal epilepsy seems reasonable and promising. Such clinical trials should be well-designed, randomized, and placebo controlled, with enough sample size and adequate follow-up of 12 months or more.
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6,600 IU vitamin D doubled levels for those with antiepileptic drugs - April 2021

Vitamin D deficiency in a Portuguese epilepsy cohort: who is at risk and how to treat
Epileptic Disord . 2021 Apr 19. doi: 10.1684/epd.2021.1268

Epilepy and Vitamin D Meta-analyses

Epileptics have slightly lower levels of Vitamin D – meta-analysis Aug 2024

Vitamin D content and prevalence of vitamin D deficiency in patients with epilepsy：a systematic review and meta-analysis Provisionally accepted
Front. Nutr. Sec. Nutritional Epidemiology Volume 11 - 2024 doi: 10.3389/fnut.2024.1439279 FREE PDF sometime in the future
Liu Yuanyuan Liu Yuanyuan 1Chao Gong Chao Gong 1Jiawei Li Jiawei Li 1Xin Ning Xin Ning 1Pei Zeng Pei Zeng 1Luchuan Wang Luchuan Wang 2Beibei Lian Beibei Lian 1Jiahao Liu Jiahao Liu 1Liya Fang Liya Fang 1Jin Guo Jin Guo 3*
1 School of Rehabilitation Medicine, Jiamusi University, Jiamusi, China
2 First Affiliated Hospital of Jiamusi University, Jiamusi, Heilongjiang Province, China
3 Jiamusi University Affiliated No.3 Hospital, Jiamusi, Heilongjiang Province, China

The prevalence of vitamin D deficiency and vitamin D levels in patients with epilepsy (PWE) were systematically evaluated, and the differences between subgroups were analyzed. We identified all articles investigating the prevalence of vitamin D deficiency in patients with epilepsy from the database established in March 2024 from PubMed, Web of Science, and Embase.
We divided them into anti-seizure medication (ASM) interventions and non-ASM interventions according to whether or not someone used ASM. A total of 68 articles were included. The prevalence of newly diagnosed epilepsy was 50.2%(95 % CI: 38.7% -61.7% ), and the prevalence after ASM intervention was 47.9%(95 % CI: 40% -55.9% ), including 7070 patients with epilepsy. Subgroup and meta-regression analyses were performed according to the diagnostic criteria, economic development level, region, age, ASM treatment, and other factors. The results showed that the differences were not significant.
In addition, the vitamin D content of epilepsy patients (18.719 ng/mL ) was lower than that of healthy people (20.295 ng/mL ).
The prevalence of vitamin D deficiency in patients with epilepsy is very high. Still, the related factors have little effect on the high prevalence of vitamin D in epilepsy, and ASM intervention can reduce the vitamin D content in patients with epilepsy. Therefore, it is emphasized that monitoring vitamin D levels is part of the routine management of patients with epilepsy.

Individuals using antiepileptic drugs need vitamin D - meta-analysis March 2020

Vitamin D Deficiency in Pediatric Patients Using Antiepileptic Drugs: Systematic Review With Meta-Analysis
Review J Pediatr (Rio J), 2020 Mar 11, DOI: 10.1016/j.jped.2020.01.004
Cíntia Junges 1, Tania Diniz Machado 2, Paulo Ricardo Santos Nunes Filho 3, Rudimar Riesgo 2, Elza Daniel de Mello 2
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Objectives: To measure the prevalence of vitamin D deficiency (through the 25-hydroxyvitamin D metabolite) in pediatric patients using antiepileptic drugs.

Source of data: Meta-analysis of studies identified through search in the PubMed, Embase, LILACS, and Cochrane Library databases, on February 19, 2019.

Summary of data: A total of 748 articles were identified, 29 of which were relevant to the objectives of this study. The prevalence of vitamin D deficiency found was 0.32 (95% CI=0.25-0.41; I2=92%, p<0.01). In the subgroup analyses, the most significant results were observed in the group of patients using cytochrome P450-inducing antiepileptic drugs, with a prevalence of 0.33 (95% CI=0.21-0.47; I2=86%, p<0.01) and, considering the study design, in the subgroup of cohort studies, with a prevalence of 0.52 (95% CI=0.40-0.64; I2=76%, p<0.01).

Conclusions: Taking into account the deleterious effects of vitamin D deficiency on the bone health of individuals using antiepileptic drugs, it is suggested to include in their care 25-hydroxyvitamin D monitoring, cholecalciferol supplementation, and treatment of the deficiency, when present.

Anti-epileptic drugs reduce Vit D, 60,000 IU monthly increases level, even with drugs – RCT Nov 2018

Effect of high dose vitamin d supplementation on vitamin d nutrition status of pre-pubertal children on anti-epileptic drugs – A randomized controlled trial
Clinical Nutrition ESPEN, https://doi.org/10.1016/j.clnesp.2018.11.007

Background and aims
Patients on long term anti-epileptic drug therapy are prone for Vitamin D deficiency for a myriad of reasons. The aim of this research was to study the effect of high dose vitamin D supplementation on vitamin D nutrition status of children newly started on anti-epileptic drug therapy.

Materials
This randomized controlled trial was conducted in a tertiary care Children's Hospital at New Delhi from November 2011 to March 2013. Eighty three children in the age group 5–10 years newly started on anti-epileptic drugs (AED) were randomized into two groups; group A – the intervention group, to whom 60,000 IU vitamin D3 was given orally/month under direct supervision along with AED for a period of 6 months, and group B- the control group, to whom AED without vitamin D3 was given. Serum 25(OH)D, ionized calcium (iCa), total calcium (tCa), inorganic phosphate (iP), alkaline phosphatase (ALP) and parathyroid hormone (PTH) levels were assayed at baseline and at the end of 6 months and were compared within and between the two groups.

Results
The mean 25(OH)D in Group A was maintained at 6 months follow up [ 26 ng/ml, 95% CI 20–34 ng/ml] compared to baseline [25 ng/ml, 95% CI −19 to 33 ng/ml] [ p = 0.83]. In group B, there was a significant decrease in 25(OH)D levels at 6 months [13 ng/ml (95% CI 9 ng/ml–17 ng/ml)] compared to baseline [18 ng/ml (95% CI 13–24 ng/ml)] [p = 0.01]. At 6 months, mean serum 25(OH)D was significantly higher in group A as compared to group B (p = 0.005).

Conclusion: To conclude, oral administration of 60,000 IU vitamin D3/month is sufficient to maintain serum 25(OH)D level and prevent development of vitamin D deficiency in children newly started on AED over a period of 6 months. Non supplementation leads to the lowering of serum 25(OH)D in these children.

Antiepileptic drugs associated with alarmingly low Vitamin D – Aug 2018

The impact of Antiepileptic drugs on Vitamins levels in epileptic patients.
Curr Pharm Biotechnol. 2018 Aug 15. doi: 10.2174/1389201019666180816104716
Shaikh AS1, Guo X1, Li Y2, Cao L2, Liu X2, Li P1, Zhang R1, Guo R1.
1 Institute of Clinical Pharmacology, Qilu Hospital of Shandong University, Jinan. China.
2 Department of Neurology, Qilu Hospital of Shandong University, Jinan. China.

BACKGROUND:
The impact of antiepileptics on serum vitamin levels is controversial and uncertain. With no clear conclusions on the impact of antiepileptics on serum levels of vitamins, there is a need for further clinical studies in order to ascertain the impact of old and newer antiepileptic drugs on serum levels of vitamins in epileptic patients, thus accomplishing a suitable usage of vitamins supplementation.

OBJECTIVE:
The intention of the present research is to confirm the hypothesis of whether or not vitamin levels are altered with antiepileptic drugs. The study also aims to reveal which vitamin levels are particularly more altered, are vitamin levels affected by gender and the type and number of antiepileptics used.

METHODS:
The present research was piloted in collaboration with the Department of Neurology in Qilu Hospital of Shandong University. A total of 63 serum samples of epileptic patients receiving antiepileptics as monotherapy or polytherapy were requested for analysis of nine vitamin serum levels. Total nine vitamins (B1, B2, B6, B9, B12, A, C, D and E) in epileptic patients receiving antiepileptic drugs were analyzed. The serum results of all vitamins were compiled and evaluated with SPSS.

RESULTS:
It was alarmingly found that serum levels of vitamin D were particularly very low in almost all (90%) epileptic patients in this study. Notably, serum levels of vitamin C and vitamin B1 were also below reference range in 72% and 46% epileptic patients, respectively. The remaining vitamins were almost in reference range for most of the patients. In our study, mean and frequency of vitamin D, C and B1 levels do not vary too much among different gender groups. The patients receiving newer antiepileptic drugs displayed a slightly increased serum vitamin D levels in comparison to the patients receiving older antiepileptic drugs. We found low vitamin D, C and B1 serum levels in patients who were on monotherapy as in comparison with patients on polytherapy.

CONCLUSION:
The most significant and surprising finding of this study revealed that serum vitamin D levels in particular were very low in almost all patients and in some patients vitamin B1 serum levels were also below the reference range. More importantly, it is first time reported here that vitamin C serum levels were also below reference range in the majority of these Chinese epileptic patients. It is recommended that all these vitamins should be regularly monitored in addition to therapeutic drug monitoring of antiepileptic drugs. Additional clinical trials are required for further evaluation. It is also recommended that epileptic patients with low serum levels of these vitamins may be prescribed vitamins supplementations with antiepileptic drugs in order to control their seizures more effectively and efficiently.

Many Antiepileptic drugs decrease Vitamin D - Feb 2017

Antiepileptic drugs reduce vitamin D levels - 2016

Effect of Antiepileptic Therapy on Serum 25(OH)D3 and 24,25(OH)2D3 Levels in Epileptic Children
Ann Nutr Metab. 2016;68(2):119-27. doi: 10.1159/000443535. Epub 2016 Jan 27.
He X1, Jiang P, Zhu W, Xue Y, Li H, Dang R, Cai H, Tang M, Zhang L, Wu Y.
Institute of Clinical Pharmacy and Pharmacology, Second Xiangya Hospital, Changsha, China.

BACKGROUND:
Vitamin D deficiency is not only associated with the adverse effects of chronic treatment with antiepileptic drugs (AEDs), but also with epilepsy. Although emerging evidence suggests that AEDs can accelerate the vitamin D catabolism, resulting in suboptimal vitamin D status, there are a limited number of studies examining the vitamin D status in epileptic patients, especially in first-episode or AEDs-naïve children.
METHODS:
Determined with high-performance liquid chromatography-tandem mass spectrometry, circulating 25(OH)D3 and 24,25(OH)2D3 levels, and 24,25(OH)2D3:25(OH)D3 ratio were compared between AEDs-treated epileptic (n = 363) and control (n = 159) children. To further figure out whether the patients were in a vitamin D deficient prone state even before treatment, epileptic children before their initiation of treatment (n = 51) were enrolled into a follow-up study.
RESULTS:
A significant decrease of 25(OH)D3 and 24,25(OH)2D3 levels, but a significant increase of 24,25(OH)2D3:25(OH)D3 ratio was observed in epileptic children, compared with controls. Baseline 25(OH)D3, 24,25(OH)2D3 and 24,25(OH)2D3:25(OH)D3 ratio in the follow-up group were similar to those in controls, but significantly changed with 2 months of AED therapy.
CONCLUSIONS:
Disturbed vitamin D levels were possibly the consequence of AED therapy, rather than the contributing factor of epilepsy. Collectively, circulating vitamin D levels should be monitored and corrected in AEDs-treated epileptic children.

Epilepsy appears to be treated by Vitamin D (starting 5,000 IU RCT) – Dec 2016

Vitamin D for the Treatment of Epilepsy: Basic Mechanisms, Animal Models and Clinical Trials
Front. Neurol. | doi: 10.3389/fneur.2016.00218
Kevin Pendo 2 and Christopher M. DeGiorgio, MD 1*
1 University of California, USA, 2 Princeton, USA

There is increasing evidence supporting dietary and alternative therapies for epilepsy, including the ketogenic diet, modified Atkins diet, and omega-3 fatty acids. Vitamin D is actively under investigation as a potential intervention for epilepsy. Vitamin D is fat soluble steroid which shows promise in animal models of epilepsy. Basic research has shed light on the possible mechanisms by which Vitamin D may reduce seizures, and animal data support the efficacy of Vitamin D in rat and mouse models of epilepsy. Very little clinical data exists to support the treatment of human epilepsy with Vitamin D, but positive findings from preliminary clinical trials warrant larger Phase I and II clinical trials in order to more rigorously determine the potential therapeutic value of Vitamin D as a treatment for human epilepsy.

From the end of the conclusion section
"Recently, our group has received an IND for a Phase I study of Vitamin D3 in drug-resistant epilepsy to study the safety, preliminary efficacy and potential cardiac benefits of Vitamin D3 5000 IU/day in drug-resistant epilepsy."
 Download the PDF from VitaminDWiki
[https://scholar.google.com/scholar?cites=10460289673450969790&as_sdt=5,48&sciodt=0,48&hl=en|30 citations of study as of Jan 2023

Epilepsy associated with low vitamin D, even before drug therapy started - Oct 2015

Vitamin D Deficiency in Children With Newly Diagnosed Idiopathic Epilepsy
J Child Neurol October 2015 vol. 30 no. 11 1428-1432
Fatma Mujgan Sonmez, MD1⇑, Ahsen Donmez, MD2, Mehmet Namuslu, MD3
Metin Canbal, MD4, Emel Orun, MD2
1Department of Child Neurology, Turgut Ozal University, Ankara, Turkey
2Department of Pediatrics, Turgut Ozal University, Ankara, Turkey
3Department of Biochemistry, Turgut Ozal University, Ankara, Turkey
4Department of Family Medicine, Turgut Ozal University, Ankara, Turkey
Fatma Mujgan Sonmez, MD, Department of Child Neurology, Turgut Ozal University, Alparslan Turkes Caddesi, No: 57 Emek, Ankara 06560, Turkey. Email: mjgsonmez at yahoo.com

VitaminDWiki Summary

14 ng for newly diagnosed vs 23 ng for controls
Suspect that newly diagnosed have not had Vitamin D-depleting drugs

Note:

  • Vitamin D appears to treat Epilepsy, and might prevent Epilepsy
  • Vitamin D is depleted by many epileptic drugs
  • People with Epilepsy should take vitamin D to avoid having health problems associated with low vitamin D, such as low bone density


Several studies have shown a link between vitamin D deficiency and epilepsy. This study includes 60 newly diagnosed idiopathic epilepsy patients and 101 healthy controls (between the ages of 5 and 16). Each group was also divided into two subgroups according to seasonal changes in terms of months of longer versus shorter daylight. We retrospectively evaluated the levels of calcium, phosphorus, alkaline phosphatase, parathyroid hormone, and 25-OH vitamin-D3 in the study participants. Levels below 20 ng/ml were defined as vitamin D deficiency and levels of 20-30 ng/ml as insufficiency. There were no significant differences in age, gender distribution and levels of calcium, phosphorus, alkaline phosphatase and parathyroid hormone between the groups. The level of 25-OH vitamin-D3 in the patient group was significantly lower when compared to the control group (p < 0.05) (14.07 ± 8.12 and 23.38 ± 12.80 ng/ml, respectively). This difference also held true when evaluation was made according to seasonal evaluation (12.38 ± 6.53 and 17.64 ± 1.14 in shorter daylight and 18.71 ± 9.87 and 30.82 ± 1.04 in longer daylight).

Idiopathic Epilepsy at AboutKidsHealth

There are a variety of idiopathic epilepsy syndromes. Children with idiopathic epilepsy may have generalized or partial seizures.
Many, although not all, idiopathic epilepsy syndromes are benign and the child will eventually grow out of them.
Relatives of a child with idiopathic epilepsy often have a history of seizures.
What are other terms for idiopathic epilepsy?
An older term for idiopathic epilepsy is primary epilepsy. The terms “idiopathic epilepsy” and “cryptogenic epilepsy” are sometimes used interchangeably, especially in older books and articles.
What causes idiopathic epilepsy?
By definition, there is no apparent underlying cause of idiopathic epilepsy, such as a structural problem with the brain or a metabolic disorder. It is possible that idiopathic epilepsy is caused by tiny abnormalities at the cellular level. We are now learning that many, although not all, idiopathic epilepsy syndromes have an associated genetic component.
In most cases, the exact way in which epilepsy is inherited is unclear. However, some researchers estimate that genes could account for 70% to 90% of the tendency to develop epilepsy.
What epilepsy syndromes are idiopathic?

  • benign epilepsy of childhood with centrotemporal spikes (BECTS)
  • childhood epilepsy with occipital paroxysms
  • benign neonatal familial convulsions
  • benign neonatal convulsions
  • benign myoclonic epilepsy in infancy
  • childhood absence of epilepsy
  • juvenile absence epilepsy
  • juvenile myoclonic epilepsy

How many other children have idiopathic epilepsy?
Idiopathic epilepsy is common; about 30% of childhood epilepsy is idiopathic.
Together, idiopathic and cryptogenic epilepsy account for 55% to 75% of cases of childhood epilepsy.
It is difficult to be precise, because different researchers define these terms differently.
How is idiopathic epilepsy treated?
Idiopathic epilepsy is treated with anti-epileptic drugs.
What is the outlook for a child with idiopathic epilepsy?
The outlook for a child with idiopathic epilepsy depends on the specific condition and how well the seizures respond to treatment.
Several idiopathic epilepsy syndromes, such as childhood absence epilepsy and BECTS, usually go away on their own.
With other syndromes, though, the child may need to take anti-epileptic drugs all his life.
Elizabeth J. Donner, MD, FRCPC, 2/4/2010

About one percent of Americans have some form of epilepsy, and nearly four percent (1 in 26) will develop epilepsy at some point in their lives. The number of Americans who have epilepsy is greater than the number who have multiple sclerosis, Parkinson's disease, and cerebral palsy combined.

 see also "Epidemiology of Idiopathic Generalized Epilepsies" - 2005 VitaminDWiki

Anti-epilepsy drugs are known to decrease Vitamin D levels, yet they still only recommend 400 IU - 2020

Should vitamin D supplementation routinely be prescribed to children receiving antiepileptic medication?
 Download the PDF from sci-hub via VitaminDWiki

See also PubMed

Image

  • Epilepsy and vitamin D: a comprehensive review of current knowledge Dec 2016, Behind a $42 paywall
    Seyed Amir Miratashi Yazdi, Mehdi Abbasi, Seyed Masoud Miratashi Yazdi; DOI: https://doi.org/10.1515/revneuro-2016-0044.
    "In this article, we review the possible relationship between vitamin D and epilepsy from different aspects, including the action mechanism of vitamin D in the central nervous system and ecological and epidemiological findings. We also present the outcome of studies that evaluated the level of vitamin D and the impact of administrating vitamin D in epileptic patients or animal subjects"

See also web

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1 in 26 will be diagnosed as Epileptic during their life

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Epilepsy Incidence Doubled in a Decade

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CBD helps some people with Epilepsy

Suspect that there are several types of Epilepsy, and that not all benefit from CBD

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