Vitamin C in Children with Idiopathic Refractory Epilepsy: Status and Effect of Supplementation

Abstract

SUMMARY O ur scope was to determine vitamin C (Ascorbic acid) status in patients with refractory idiopathic epilepsy and comparing it to that of apparently normal children, and to find out whether vitamin C supplementation for 30 days would improve seizure frequency and EEG findings of children with refractory epilepsy. This study was conducted in Ain Shams University hospitals, Pediatric Neurology Clinic, on 60 children with age range from 3-16 years, who were classified as follows:  Group 1: Thirty children with refractory idiopathic epilepsy, were all subjected upon recruitment to detailed history taking (stressing on the duration and type of seizures, chalfont seizure severity scale and antiepileptic drugs used), clinical examination, documentation of EEG finding and determination of serum level of vitamin C. Then patients have been supplemented for 30 days with a daily single oral dose of vitamin C after which, they were reassessed for seizure frequency, Chalfont seizure severity scale, EEG finding and serum level of vitamin C.  Group 2: Thirty age and sex matched apparently normal children enrolled as controls; they had been recruited from the siblings of the children attending the Outpatients' clinic. The control group underwent venous sampling for serum level of vitamin C once. The results of our study revealed:  Serum vitamin C level was significantly lower in patients with refractory idiopathic epilepsy compared to controls.  Serum vitamin C level was significantly lower in patients receiving triple or double AEDs compared to those on single AED.  After30 days of supplementation, vitamin C level significantly increased in the supplemented group and there was no significant difference between the post supplementation level and the control.  Seizure frequency and chalfont seizure severity scale were significantly improved after vitamin C supplementation compared to the initial recruitment data, while there is no significant changes in EEG findings may be due to the short period of supplementation.  There was a significant negative correlation of vitamin C serum level and the duration of epilepsy.  There was a significant negative correlation of vitamin C serum level and the dose of levetiracetam.  There was no significant correlation between mean serum level of vitamin C and Chalfont seizure severity scale, frequency of seizures per week, duration or doses of other antiepileptic drugs used.  Wrapping up, the oxidative stress may be implicated in the pathogenesis of refractory epi