Vitamin D Supplementation To Prevent Vitamin D Deficiency For Children With Epilepsy: A Randomized Controlled Trial

Objective:Antiseizure medications decrease the level of vitamin D.Additionally, low vitamin D levels tend to increase seizure frequency in children with epilepsy.We aimed to determine if 400 IU daily versus 1000 IU daily would be sufficient to maintain optimal 25(OH) vitamin D concentration in children with epilepsy. Methods:A phase IV randomized controlled open-label trial.We recruited children aged 2–16 years diagnosed with epilepsy from December 2017 to March 2021. Children with vitamin D concentration <75 nmol/L were treated with Cholecalciferol before randomization. Eligible children with vitamin D concentration above 75 nmol/l were randomized to receive a maintenance dose of either 400 IU/day or 1000 IU/day of Cholecalciferol. Results:We assessed 163 children, 90 children on monotherapy, and 25 children on polytherapy.For the monotherapy group, the proportion of children with 25(OH)vitD concentration < 75 nmol/l was 36 (75.0%) in the group receiving 400 IU and 23 (54.8%) in the group receiving 1000 IU.The change in 25(OH)vitD concentration from randomization tell 6 months was -38.13+/-31.26 in the 400 IU group, and -30.54+/45.28 in the 1000 IU (P-value 0.38). In the monotherapy group, 68(69%) were seizure-free at baseline,post-treatment of vitD deficiency 82(83.6%) were seizure-free. Conclusion: VitD 1000 IU was superior to 400 IU in preventing VitD deficiency among children receiving monotherapy. Correcting vitamin D deficiency status led to better seizure control.