Vitamin D status in children with intractable epilepsy, and impact of the ketogenic diet.
OBJECTIVE
The aim of this study was to describe vitamin D status in children with intractable epilepsy prescribed newer antiepileptic drugs (AEDs) before initiation of and during 15-month treatment with the ketogenic diet (KD).


METHODS
Serum vitamin D (25-OHD and 1,25-OHD) and parathyroid hormone (PTH) were assessed in prepubertal children with intractable epilepsy before initiation of and during KD therapy. Three-day weighed dietary records including KD and vitamin and mineral supplementation were obtained at baseline and at 1 month.


RESULTS
Forty-five children (aged 5.1 +/- 2.7 years) were enrolled. Before KD therapy, 4% had deficient and 51% had insufficient serum 25-OHD levels. Vitamin D intake was less than recommended in 47%. Adequate vitamin D intake, fewer AEDs, and generalized seizures were associated with higher serum 25-OHD levels (p < 0.01). After 3 months on the KD, 25-OHD levels increased (p < 0.001), and PTH declined (p < 0.001). Over the next 12-month period, 25-OHD levels steadily declined (p < 0.001), and PTH did not significantly change.


CONCLUSIONS
Children with intractable epilepsy treated with newer AEDs had poor vitamin D status. Their status improved over the first 3 months of KD therapy with vitamin D supplementation and slowly declined thereafter.
Bergqvist
A G Christina
AG
Division of Neurology, The Children's Hospital of Philadelphia, Department of Pediatrics and Neurology, University of Pannsylvania School of Medicine, Philadelphia, Pennsylvania, USA. bergqvist@email.chop.edu
Schall
Joan I
JI
Stallings
Virginia A
VA
D015652:25-Hydroxyvitamin D 2 / Q000097:blood / Q000172:deficiency; D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects*; D002648:Child; D002675:Child, Preschool; D004041:Dietary Fats / Q000008:administration & dosage* / Q000378:metabolism; D019587:Dietary Supplements; D004827:Epilepsy / Q000097:blood* / Q000178:diet therapy* / Q000188:drug therapy; D005260:Female; D006801:Humans; D007223:Infant; D007662:Ketosis / Q000378:metabolism; D008137:Longitudinal Studies; D008297:Male; D009752:Nutritional Status; D010281:Parathyroid Hormone / Q000097:blood; D012621:Seasons; D014807:Vitamin D / Q000097:blood*; D014808:Vitamin D Deficiency / Q000097:blood* / Q000139:chemically induced
D000927:Anticonvulsants; D004041:Dietary Fats; C470125:PTH protein, human; D010281:Parathyroid Hormone; D014807:Vitamin D; D015652:25-Hydroxyvitamin D 2