Children who suffer from seizures may benefit from vitamin D supplements

02.2025
Author Dr. Martin Claßen, Bremen

Anticonvulsant medication is the main treatment for children who suffer from seizures. Some of this medication has negative impacts on the vitamin D balance, which means vitamin D levels need to be monitored. In a randomised, controlled study in Saudi Arabia, 163 children aged between 2 and 16 with epilepsy who were taking anticonvulsant medication were given different doses of vitamin D (400 IU versus 1000 IU), after an existing vitamin D deficiency was first corrected. The children with levels above 75nmol/l were then randomised to receive either 400 IU or 1000 IU vitamin D. After 3 months, the levels and calcium metabolism parameters were measured. 
90 children were given anticonvulsant monotherapy, and 25 were given multiple anticonvulsants. At the start of the study, 74.2% of the participants had vitamin D levels below 75 nmol/l. Even after 6 months, the lower dose still resulted in reduced levels in 75%, while it was 54.8% among the 1000 IU group. However, the most remarkable finding was the increase in the number of seizure-free children in the monotherapy group from 68/98 to 82/98 (increase from 69.4% to 83.7%) after correcting the vitamin D deficiency.

Comment: As well as its effects on calcium balance, bone density and bone mass, vitamin D plays an important role in many organs and tissues including the immune system, the intestine and the central nervous system. However, the effects of routinely taking supplements are highly controversial. Given the frequency of vitamin D deficiency and the potential effects of anticonvulsants on vitamin D levels, it seems sensible to investigate the necessary dose and the effects of taking supplements. Older, uncontrolled studies have indicated that this may have an effect on the frequency of seizures. I am amazed by the effect on seizures demonstrated in the study – it should be reviewed in Central Europe as multicentrically as possible. Until further data becomes available, there is a lot to be said for giving at least 1000 IU vitamin D supplements to children as part of anticonvulsant therapy, at least in winter. I find the high rate of vitamin D deficiency (around 75%) remarkable in a country much closer to the equator than Germany, which might make us critically re-examine the “normal value”. I also think it is remarkable that a deficiency often persisted with both doses, which would be an argument for a higher replacement dose.

Reference:
Bashiri FA, Hudairi A, Hamad MH, Al-Sulimani LK, Al Homyani D, Al Saqabi D, Kentab AY, Al Khalifah RA. Vitamin D Supplementation for Children with Epilepsy on Antiseizure Medications: A Randomized Controlled Trial. Children (Basel). 2024 Sep 28;11(10):1187. doi: 10.3390/children11101187.