Drug-Resistant Epilepsy is more common if lower level of vitamin D - meta-analysis

Impact of vitamin D supplementation and status on seizure frequency and quality of life in drug-resistant epilepsy: A systematic review and meta-analysis

Epileptic Disord . 2026 Jun 1. doi: 10.1002/epd2.70294 PDF behind paywall. You can rent PDF for $10

Bassel Alrabadi 1, Hasan I Matar 1, Natalie Bandak 1, Yamen Refai 1, Fadi Alrabadi 2, Omar Alomari 3

Background: Drug-resistant epilepsy (DRE) affects approximately one-third of patients with epilepsy and is associated with significant morbidity and reduced quality of life. Emerging evidence suggests that vitamin D may influence neuronal excitability and neuroinflammatory pathways, potentially impacting seizure control.

Objective: To systematically evaluate the effect of vitamin D supplementation and baseline vitamin D status on seizure frequency, biochemical outcomes, and quality of life in patients with drug-resistant epilepsy.

Methods: PubMed, Scopus, and Web of Science were searched from inception through March 2026. Eligible studies assessed vitamin D supplementation or serum vitamin D levels in DRE patients.

Results: Eleven studies were included, with four studies (n = 183) contributing to the meta-analysis of supplementation outcomes. Vitamin D supplementation was associated with a significant reduction in seizure frequency (mean difference [MD] = -8.31 seizures/month, 95% CI [-13.38, -3.25], p = .001) and a significant increase in serum vitamin D levels (MD = 18.4 nmol/L, 95% CI [4.26, 32.54], p = .01). No significant difference in baseline vitamin D levels was observed between drug-resistant and drug-responsive epilepsy (MD = .79 nmol/L, 95% CI [-.31, 1.89], p = .16). Qualitative findings suggested potential improvements in quality of life and fatigue with long-term supplementation, although short-term effects and neuroinflammatory marker changes were inconsistent.

Conclusion: Vitamin D supplementation is a safe adjunctive therapy that may reduce seizure frequency in drug-resistant epilepsy, though further large-scale trials are needed to confirm its efficacy and define optimal use.


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