Serum vitamin D level and its association with anti-seizure medications in children with seizure disorder

doi:10.12998/wjcc.v14.i16.120945

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World Journal of Clinical Cases

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2307-8960

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Clin Cases. Jun 6, 2026; 14(16): 120945
Published online Jun 6, 2026. doi: 10.12998/wjcc.v14.i16.120945

Serum vitamin D level and its association with anti-seizure medications in children with seizure disorder

Partha Sarathi Sahoo, Debi Prasad Jena, Pravakar Mishra, Pratima Kumari Sahu, Rashmi R Das

Partha Sarathi Sahoo, Debi Prasad Jena, Pravakar Mishra, Department of Pediatrics, SCB Medical College, Cuttack 753007, Odisha, India

Pratima Kumari Sahu, Department of Biochemistry, SCB Medical College, Cuttack 753007, Odisha, India

Rashmi R Das, Department of Pediatrics, All India Institute of Medical Sciences, Bhubaneswar 751019, Odisha, India

Co-first authors: Partha Sarathi Sahoo and Rashmi R Das.

Author contributions: Sahoo PS, Jena DP, Sahu PK, and Mishar P contributed to material preparation, and data acquisition; Sahoo PS, Jena DP, and Das RR contributed to data analysis; Sahoo PS, Mishra P, Das RR, and Sahu PK contributed to conceptualization and design; and all authors contributed to writing draft and writing revision and approved to submit the final version.

Institutional review board statement: The study was reviewed and approved by the Institute Ethics Committee, SCB Medical College & Hospital, Cuttack (Approval No. 1547; Dated: 23 November 2023).

Clinical trial registration statement: In India, the registration of a prospective (non-intervention) study is not mandatory. So, this study was not registered.

Informed consent statement: All study participants, or their legal guardians, provided written consent prior to study enrolment.

Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.

CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.

Data sharing statement: There is no additional data available.

Corresponding author: Rashmi Ranjan Das, MD, FCCP, Professor, Department of Pediatrics, All India Institute of Medical Sciences, OPD Block, Sijua, Patrapada, Bhubaneswar 751019, Odisha, India. ped_rashmi@aiimsbhubaneswar.edu.in

Received: March 13, 2026
Revised: April 18, 2026
Accepted: May 6, 2026
Published online: June 6, 2026
Processing time: 71 Days and 6.9 Hours

Abstract

BACKGROUND

Vitamin D deficiency is frequently reported in children with epilepsy and may be influenced by antiseizure medications (ASMs). However, prospective longitudinal data evaluating this relationship remain limited.

AIM

To assess longitudinal changes in serum vitamin D levels and examine their association with seizure control in children receiving ASMs.

METHODS

In this prospective longitudinal study, children aged 1-14 years with seizure disorders on ASM therapy were enrolled and followed for 18 months. Serum 25-hydroxyvitamin D levels were measured at baseline, 6 months, and 18 months using chemiluminescent immunoassay. Seizure control was defined as seizure freedom for ≥ 6 months prior to evaluation. Longitudinal trends were analyzed using linear mixed-effects models, and multivariable regression was performed to adjust for potential confounders.

RESULTS

A total of 150 children were included (44.7% aged 1-5 years; 64.7% male). Mean serum vitamin D levels showed a declining trend from 21.33 ng/mL at baseline to 18.61 ng/mL at 18 months; however, this change was not statistically significant (P = 0.65). Longitudinal analysis also did not demonstrate a significant trend (P = 0.41). Low vitamin D levels (insufficiency + deficiency) were observed in 80.7% of participants. No independent association was found between vitamin D levels and seizure control (P = 0.054).

CONCLUSION

Vitamin D insufficiency is highly prevalent among children with epilepsy receiving ASMs. Although a non-significant declining trend in vitamin D levels was observed over time, no independent association with seizure control was identified. These findings are associative and hypothesis-generating.

Keywords: Pediatric epilepsy; Vitamin D; Antiseizure medications; Seizure control; 25-hydroxyvitamin D

Core Tip: In this prospective longitudinal study of 150 children with epilepsy, vitamin D insufficiency was highly prevalent, affecting over 80% of participants. Although serum vitamin D levels showed a declining trend during follow-up, the change was not statistically significant, and no independent association with seizure control was observed. These findings suggest that while hypovitaminosis D is common in this population, its direct impact on seizure outcomes remains uncertain and warrants further controlled studies.