Abstracts

Rationale: There exist few observational studies reporting the modulation of neuronal excitability by vitamin (vit), esp. B, D, E and Q, could potentially be effective in treating neuronal hyperexcitability disorders, such as epilepsy. They are relatively safe in terms of adverse effect. We aimed to investigate if addition of multivitamin therapy (B6/B9, D, E and Q) to regular AED therapy could further ameliorate seizures in patients with refractory focal epilepsy, and to assess the long-term safety and tolerability of multivitamin therapy.  Methods: We conducted a prospective cohort study to investigate the efficacy and tolerability of addition of multivitamin therapy (daily dose: B6 100mg, B9 5 mg, D 1000 IU, E 400 IU and Q10 90 mg) in patients with intractable focal epilepsy who were under at least two antiepileptic drugs therapy. All patients had more than one seizures during the four-week baseline period and returned at week four, 12 and 24 for efficacy and safety assessment. All baseline antiepileptic drugs were maintained at a stable dose throughout the study. All the treatment-emergent adverse effects were recorded.  Results: We have recruited 31 patients (10 men and 21 women) with age ranging from 21-64 years (Men 44.2 +- 4.3), women 40.9 +- 1.8)). The average seizure frequency per month was 4.95 +- 0.80 at baseline; 2.06 +- 1.1 after addition of vitamins at the third month and 1.29 +- 1.4 at the sixth month. The addition of multi-vitamins to the baseline antiepileptic drugs reduced seizures significantly, in terms of 50% responder rate (p< 0.05). As to safety and tolerability, most of the patients did not experience any significant treatment emergent adverse events, and only four patients experienced minor events, including mild headache, dizziness and skin rashes. Three patients reported seizure worsening and they were all taking levetiracetam in common (one with concurrent perampanel, one with lamotrigine and one without any other drug).  Conclusions: Our study demonstrated the therapeutic potential and relatively good tolerability of add-on multivitamin therapy in patients with refractory focal epilepsy.  Funding: Ministry of Science and Technology, Taiwan (107-2314-B-006-018, 107-2320-B-006-019)