Lead investigator András Holló and company measured baseline levels of vitamin D in 13 subjects. Ten of the subjects had localization-related epilepsy, two had Lennox-Gastaut syndrome and one subject was diagnosed with idiopathic generalized epilepsy. The subjects’ ages ranged between 19-60 years and had epilepsy from 10 to 42 years. Median serum levels at baseline were 11.8 ng/ml, ranging from less than 4 ng/ml to 34.2 ng/ml. Eight of the patients had levels less than 12 ng/ml.
The investigators corrected deficiency in all 13 subjects by administering a one-time 40,000-200,000 IU dose of vitamin D3 to treat deficiency, and then administering a 2,000-2,600 IU daily dose of vitamin D3 for 3 months. The aim of treatment was to raise levels above 30 ng/ml. After a three month follow-up, the median 25(OH)D level was 38 ng/ml, ranging from 23.3-45 ng/ml.
They compared the number of seizures in this 3 month period with the 3 month period beforehand. The results were as follows:
10 of the 13 subjects exhibited a decrease in number of seizures
2 of the 13 subjects exhibited an increase in number of seizures
One of the subjects had exactly the same number of seizures
Overall, there was a median seizure number reduction of 40%, and this was statistically significant (p=.04)
A seizure reduction of greater than 50% was experienced in five patients
In the subject who started with a level less than 4 ng/ml and raised their level to 43.1 ng/ml, they experienced a reduction in number of seizures from 450 to 30 over three month intervals
The authors offered no mechanistic explanation for the results. They did point out that vitamin D receptors and enzyme activators are present in the brain. In the patient who had a level lower than 4 ng/ml and 450 seizures in three months, you can’t help but speculate that low serum calcium may have played a role in that subject’s seizure frequency.
Study limitations include small number of patients and lack of a placebo to compare to. This study certainly warrants a randomized controlled trial, and it also highlights the importance of correcting vitamin D deficiency in epilepsy patients. There is no harm in treating vitamin D deficiency, and this pilot study shows that epilepsy patients could be much better off with a simple maintenance dose of vitamin D.
The Vitamin D Council recommends a maintenance dose of 5,000 IU/day for adults and 1,000 IU/day for every 25lbs of body weight in children to sustain vitamin D sufficiency. Click here to comment on this blog
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