Abstracts

Rationale: In Ramadan, the ninth month of the Islamic calendar, adult Muslims are required to fast. Fasting in Ramadan involves refraining from taking any food, beverages or oral medications from dawn to sunset. The effect of this fasting on seizure control has not been well studied. A literature review returns only two observational studies on this subject with variable and inconclusive results. Our aim is to study whether fasting in Ramadan has an effect on seizure control and quality of life in adult patients with epilepsy. Methods: This is a prospective observational study over 3 months period (one month before fasting, the fasting month and one month after fasting). We recruited adult patients with epilepsy who are able to fast during the month of Ramadan. Outcome measures are 1) Level of seizure control; 2) Quality of life score using the Arabic version of Ferrans & Powers Quality of Life Index (QLI). Changes of anticonvulsants were not allowed during the study period. We collected data on patient demographics, clinical characteristics of seizures, classification of epilepsy and antiepileptic medications used. We used seizure log to record numbers of seizures during the 3 months period. Quality of life was scored at the end of each month of the study period. Results: 40 patients were included in the study, 24 (50%) males. Ages are 14-51 years (mean 27.8 years). Epilepsy was classified as focal in 64% of patients, multifocal in 12% and generalized in 24%. During the study period, all patients were on antiepileptic polytherapy (2-5 anticonvulsants, average 2.6). Preliminary results show that about half of the patients had no change of their seizure frequency during the fasting month. Another 30% experienced some improvement of their seizure control whereas the rest reported a moderate increase of their seizures. QLI total score declined in 40% of patients in Ramadan, increased in 36% and didn’t change in 24%. When calculating the score for health and function subscale, 56% reported increased scores, 23% declined and 21% remained unchanged. Conclusions:  Fasting in Ramadan has a neutral effect on seizure control in adult patients with epilepsy. Effects of fasting on quality of life scale were variable with most positive impact is seen in health and function subscale. Funding: None