Unraveling the nutritional challenges in epilepsy: Risks, deficiencies, and management strategies: A systematic review

Table 3 Summary of quality assessment and key findings from studies on food supplements and seizures¹

Ref.	Supplement studied	Sample size (n)	Risk of bias (Cochrane tool)	Main outcome	Statistical findings (P value, 95%CI, etc.)
Schauwecker et al[189], 2012	Glycemic control	Animal study	Moderate (preclinical, no human data)	Glycemic modulation affects seizure-induced brain injury	Glucose rescue reduced hippocampal pathology (P < 0.001)
Hamerle et al[204], 2018	Alcohol	310	Moderate (retrospective, self-reported)	Alcohol-related seizures linked to heavy consumption	OR = 5.79 for genetic epilepsy, OR = 8.95 for chronic alcohol use
Samsonsen et al[206], 2018	Alcohol	134	Moderate (observational, cross-over design)	Hazardous drinking and sleep deprivation linked to seizures	AUDIT score ≥ 8 in 28% of patients, seizures peaked on Sundays and Mondays
Pelliccia et al[211], 1999	Food allergy	3 (case report)	Not applicable	Seizures improved with cow’s milk elimination	EEG normalized after diet change (no statistical data)
Silverberg et al[212], 2014	Allergic disease	91642 (population-based)	Low (large sample, well-controlled)	Allergies associated with increased epilepsy risk	OR = 1.79 (95%CI: 1.37-2.33) for ≥ 1 allergic disease, OR = 2.69 (95%CI: 1.38-4.01) for food allergies
Gorjipour et al[220], 2019	Hypoallergenic diet	34	Moderate (quasi-experimental, no blinding)	Significant reduction in seizure frequency in children with food allergies	50% seizure-free after 8 weeks, 85% had ≥ 50% reduction (P < 0.001)
Sarlo et al[222], 2023	Low glutamate diet	33	Moderate (non-blinded, small sample)	No significant seizure reduction, but 21% were clinical responders	Clinical response likelihood decreased with age (OR = 0.71, 95%CI: 0.50-0.99, P = 0.04)
Kaufman et al[224], 2003	Caffeine	Case report	Not applicable	Excessive caffeine worsened seizure control	Seizures reduced with caffeine elimination (no statistical data)
Tényi et al[234], 2021	Food intake	100 (596 seizures analyzed)	Low (well-controlled, EEG-monitored)	Food intake significantly precipitated temporal lobe seizures esp. in males	Shorter food-seizure latency linked to less severe seizures (P < 0.05)

¹This table summarizes randomized controlled trials and relevant studies investigating the effects of dietary factors, food allergies, alcohol, caffeine, and glycemic control on epilepsy and seizure disorders.

OR: Odds ratio; EEG: Electroencephalogram.