Serum vitamin D status in children with epilepsy on antiepileptic drugs and its relation to the frequency of breakthrough seizures


  • Gayatri Bezboruah Department of Pediatrics and Neonatology, Gauhati Medical College and Hospital, Guwahati, Assam, India
  • Shabnam Kalita Department of Pediatrics and Neonatology, Gauhati Medical College and Hospital, Guwahati, Assam, India



Epilepsy, Vitamin D, Antiepileptic drugs, Breakthrough seizures


Background: Epilepsy is the most common neurological disorder in children requiring long term drug therapy which are associated with vitamin D deficiency. Antiepileptic actions of vitamin D deficiency have been extensively studied in animal models but human data, particularly in children is lacking. Objectives were to study the levels of serum vitamin D in children with epilepsy on antiepileptic drugs and to study the correlation between levels of vitamin D and frequency of breakthrough seizures.

Methods: hospital-based cross-sectional study. Participants: A total of 94 children with epilepsy were included in the study. Intervention: The patients were on a minimum of 6 months of antiepileptic drug therapy. Anthropometric measurements were taken and blood samples were analysed for vitamin D, serum calcium, phosphate, complete blood counts and renal profile.

Results: The present study showed a statistically significant relationship between serum vitamin D deficiency and antiepileptic drugs (p value <0.001), the number of AEDs with patients on polytherapy ≥2 AEDs having lower vitamin D levels (p value <0.001) and the duration of antiepileptic drugs (p value of 0.016). Linear regression analysis also showed a statistically significant relationship between serum vitamin D deficiency and seizure frequency (p value of <0.001, 95% confidence interval: -3.465, -2.275).

Conclusions: Case studies and epidemiological data also support the evidence of connection between levels of serum vitamin D and epilepsy and the use of vitamin D3 as a potential therapy for human epilepsy. This study is conducted with an aim to highlight the role of vitamin D in children with epilepsy in seizure control.


Fisher RS, van Emde Boas W, Blume W, Elger C, Genton P, Lee P et al. Epileptic seizures and epilepsy: definitions proposed by International League Against Epilepsy (ILAE) and the International Bureau of Epilepsy. Epilepsia. 2005;26(4):470-2.

Fine A. Wirrell EC. Seizures in Children. Pediatr Rev. Am Acad Pediatr. 2020;41(7);321-47.

Panagariya A, Sharma B, Dubey P, Satija V, Rathore M. Prevalence, Demographic profile and Psychological Aspects of Epilepsy in North-Western India: A Community Based Observational Study. Ann Neurosci. 2018;25(4):177-86.

Cebeci AN, Ekici B. Epilepsy Treatment by Sacrificing Vitamin D. Expert Rev Neurother. 2014;14(5):481-91.

Fong CY, Riney CJ. Vitamin D Deficiency Among Children with Epilepsy in South Queensland. J Child Neurol. 2014;29(3):368-73.

Oner N, Kaya M, Karasalihoğlu S, Karaca H, Celtik C, Tütüncüler F. Bone Mineral Metabolism Changes in Epileptic Children Receiving Valproic Acid. J Pediatr Child Health. 2004;40(8):470-3.

Scheffer IE, Berkovic S, Capovilla G, Connolly MB, French J, Guilhoto L, et al. ILAE classification of the epilepsies: Position paper of the ILAE Commission for Classification and Terminology. Epilepsia. 2017; 58(4):512-21.

Sonmez FM, Donmez A, Namuslu M, Canbal M, Orun E. Vitamin D deficiency in Children with newly diagnosed idiopathic epilepsy. J Child Neurol. 2015; 30(11):1428-32.

Shellhaas RA, Barks AK, Joshi SM. Prevalence and risk factors for vitamin D insufficiency among children with epilepsy. Pediatr Neurol. 2010;42(6):422-6.

Nettekoven S, Strohle A, Trunz B, Wolters M, Hoffmann S Horn R et al.. Effects of antiepileptic drug therapy on vitamin D status and biochemical markers of bone turnover in children with epilepsy. Eur J Pediatr. 2008;167(12):1369-77.

Christiansen C, Rodbro P, Sjö O. Anticonvulsant action of vitamin D in epileptic patients? A controlled pilot study. Br Med J. 1974;2(5913):258-9.

Holló A, Clemens Z, Kamondi A, Lakatos P, Szucs A. Correction of vitamin D deficiency improves seizure control in epilepsy: a pilot study. Epilepsy Behav. 2012;24(1):131-3.

Patil N, Rai S. Study of Vitamin D in Epileptic Children in Age Group of 2-16 years. Asian J Pharm Clin Res. 2015;8(2):241-3.

Nagarjunakonda S, Amalakanti S, Uppala V, Rajanala L, Athina S. Vitamin D in epilepsy patients, patients on antiepileptic drug polytherapy and drug-resistant epilepsy sufferers. Eur J Clin Nutr. 2016;70(1):140-2.

Fong CY, Kong AN, Poh BK, Mohamed AR, Khoo TB, Ng RL et al. Vitamin D Deficiency and its Risk Factors in Malaysian Children with Epilepsy. Epilepsies. 2016;57(8)1271-9.

Nicolaidou P, Georgouli H, Kotsalis H, Matsinos Y, Papadopoulou A, Fretzayas A et al. Effects of Anticonvulsant Therapy on Vitamin D Status in Children: Prospective Monitoring Study. J Child Neurol. 2006;21(3):205-9.

Akman O, Tumer L, Hasanoglu A. Frequency of vitamin d insufficiency in healthy children between 1-16 years of age in Turkey. Pediatr Int.2011;53:968-73.

Chaudhuri JR, Mridula KR, Rathnakishor C, Balaraju B, Bandaru VS. Association of 25-Hydroxy Vitamin D Deficiency in Pediatric Epileptic Patients. Iran J Child Neurol. 2017;11(2):48-56.

Bergqvist AG, Schall JI, Stallings VA. Vitamin D status in children with intractable epilepsy and impact of ketogenic diet. Epilepsia. 2007;48(1):66-71.

Chandrika A, Guglani V, Kaur J, Aulakh R, Singh S, Banga S. Vitamin D status of Epileptic Children in India: A Prospective Cross-Sectional Study From a Tertiary Care Centre. J Child Sci. 2020;10:e87-92.

Seung HL, Yu J. Risk factors of vitamin D deficiency in children with epilepsy taking anticonvulsants at initial and during followup. Ann Pediatr Endinocrinol Metab. 2015;20(4):198-205.

Siegel A, Malkowitz L, Moskovits MJ, Christakos S. Administration of 1, 25-dihydroxyvitamin D 3 results in the elevation of hippocampal seizure threshold levels in rats. Brain Res. 1984;298(1):125-9.

Kalueff AV, Minasyan A, Touhimaa P. Anticonvulsant effects of 1,25-dihydroxyvitamin D in chemically induces seizures in mice. Brain Res Bull. 2005;67(1-2):156-60.






Original Research Articles