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Brief Communication
a r t i c l e i n f o a b s t r a c t
Article history: There is growing interest concerning the role of vitamin D in various medical conditions such as diabetes and
Received 16 January 2012 oncological, cardiovascular and central nervous system disorders. Although vitamin D deciency is known to
Revised 1 March 2012 be highly prevalent among epilepsy patients, only a single study, published nearly forty years ago, assessed
Accepted 3 March 2012
the effect of vitamin D on seizure control. Here, we measured serum 25-hydroxy-vitamin D (25(OH)D) levels
Available online 11 April 2012
and normalized it by administration of vitamin D3 in 13 patients with pharmacoresistant epilepsy. To see if
Keywords:
vitamin D3 has an impact on seizure frequency, we compared seizure numbers during a 90-day period
Vitamin D before and after treatment onset. We found that seizure numbers signicantly decreased upon vitamin D3
Hypovitaminosis D supplementation. Median seizure reduction was 40%. We conclude that the normalization of serum vitamin
Neurosteroids 25(OH)D level has an anticonvulsant effect.
Seizure control 2012 Elsevier Inc. All rights reserved.
Pharmacoresistant epilepsy
1. Introduction 2. Methods
Besides its well-known importance in bone health, there is growing Thirteen consecutive epilepsy patients were recruited from two ep-
interest for widespread functions of vitamin D such as preventing ilepsy outpatient clinics (National Institute of Neuroscience, Budapest,
oncological [1] and cardiovascular diseases [2], infections [3] and dia- Hungary; National Institute for Medical Rehabilitation, Budapest,
betes [4] and lowering general mortality [5]. Poor vitamin D status Hungary). Inclusion criteria were pharmacoresistance, keeping a reli-
has also been implicated in the pathogenesis of dementias [6,7], able seizure diary, good compliance, lack of psychogenic seizures and
Parkinson's disease [8], multiple sclerosis [9] and schizophrenia [10]. no change of antiepileptic medication during the previous 3 months.
Regarding epilepsy, several studies indicate increased risk for bone Pharmacoresistance was dened as persisting seizures after a minimum
loss in patients on antiepileptic medication as well as low levels of of two antiepileptic drugs [22]. In fact, all patients underwent several
serum 25(OH)D, the major circulating form of vitamin D3 [1113]. In failed trials of antiepileptic drug schedules. Upon patient selection,
contrast to the above-mentioned antiepileptic drug-related studies, we ascertained that patients had a reliable seizure diary kept either by
fewer studies have addressed the relation between vitamin D and the patients themselves (n = 10) or their caregivers (n= 3). Seizure
epilepsy itself. There is one study addressing the effect of vitamin D data from pre-existing seizure diaries were used as a baseline. In
supplementation on seizures in a group of patients with pharmacore- those cases where caretakers tracked seizures, these persons were the
sistant epilepsy. This study [14], published nearly forty years ago, same throughout the entire 6 months of the study. Ten patients had
showed that administration of vitamin D2 resulted in a seizure reduc- localization-related epilepsy, two had LennoxGastaut syndrome, and
tion of 30% on average. A few case studies [1518] suggested a link be- one patient was diagnosed with idiopathic generalized epilepsy. All pa-
tween maternal vitamin D deciency and newborn seizures eliminated tients were on antiepileptic polytherapy that was unchanged during the
by vitamin D treatment. Since animal studies [1921] also support an entire study period. Patient characteristics are presented in Table 1. The
anticonvulsant effect of vitamin D, we asked the question whether study was approved by the local ethics committee, and patients gave
supplementation of vitamin D3, the physiological form of vitamin D, written informed consent to participate in the study. The study was
may result in improved seizure control in patients with pharmacore- performed in accordance with the ethical standards laid down in the
sistant epilepsy. To assess this, serum 25(OH)D levels were measured 1964 Declaration of Helsinki.
and corrected in 13 epilepsy patients, and corresponding changes in sei- Vitamin D status was assessed by measuring serum 25(OH)D
zure numbers were analyzed. levels (Liaison, DiaSorin, Stillwater, MN, USA). In addition to this, the
following assessments were performed: complete blood count, renal
functions, serum antiepileptic drug levels, and calcium and phosphate
Corresponding author. Fax: + 36 1 255 8869. levels. Low levels of vitamin D were corrected according to the new
E-mail address: clemenszsoa@gmail.com (Z. Clemens). practice guideline on vitamin D deciency by Holick et al. [23].
1525-5050/$ see front matter 2012 Elsevier Inc. All rights reserved.
doi:10.1016/j.yebeh.2012.03.011
132 A. Holl et al. / Epilepsy & Behavior 24 (2012) 131133
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