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

Table 4 The potential links between various vitamin deficiencies and epilepsy

Vitamin	Role in epileptogenesis	Associated conditions	Causes of deficiency	Treatment/management	Daily recommended dose
Vitamin A	Limited evidence of anti-epileptogenic effects by impacting synaptic plasticity, memory impairment, convulsions	Night blindness, xerophthalmia, weakened immune system, skin changes, and impaired growth and development	Dietary Insufficiency, Malabsorption, poor liver function, rapid growth rates in infancy and childhood	Chronic β-carotene/vitamin A intake; Retinoic acid as potential antiepileptic agent	Infants 0-6 months: 400 mcg/day. Infants 7-12 months: 500 mcg/day. Children 1-3 years: 300 mcg/day.Children 4-8 years: 400 mcg/day. Boys 9-13 years: 600 mcg /day. Girls 9-13 years: 600 mcg/day. Male ≥ 14 years: 900 mcg/day. Females ≥ 14 years: 700 mcg/day
Thiamine (B1)	Essential for nerve function; deficiency linked to seizures; associated with Wernicke's encephalopathy	Wernicke's encephalopathy; chronic alcohol abuse; poor nutrition	Alcoholism, inadequate dietary intake	Thiamine supplementation and addressing the underlying causes	Infants 0-6 months: 0.2 mg/day. Infants 7-12 months: 0.3 mg/day. Children 1-3 years: 0.5 mg/day. Children 4-8 years: 0.6 mg/day. Boys 9-13 years: 0.9 mg/day. Girls 9-13 years: 0.9 mg/day. Teenagers 14-18 years: 1.2 mg/day. Adult men: 1.2 mg/day. Adult women: 1.1 mg/day. Pregnant women: 1.4 mg/day. Breastfeeding women: 1.4 mg/day
Riboflavin (B2)	Important for mitochondrial function; deficiency implicated in riboflavin-responsive epilepsy	Riboflavin-responsive epilepsy; mitochondrial dysfunction	Uncommon in developed countries	Riboflavin supplementation; genetic testing for riboflavin-responsive epilepsy	Infants 0-6 months: 0.3 mg/day. Infants 7-12 months: 0.4 mg/day. Children 1-3 years: 0.5 mg/day. Children 4-8 years: 0.6 mg/day. Children 9-13 years: 0.9 mg/day. Teenagers 14-18 years: Boys: 1.3 mg/day. Girls: 1.0 mg/day. Adult men: 1.3 mg/day. Adult women: 1.1 mg/day. Pregnant women: 1.4 mg/day. Breastfeeding women: 1.6 mg/day
Pyridoxine (B6)	Vital for neurotransmitter synthesis; deficiency linked to pyridoxine-dependent epilepsy	Pyridoxine-dependent epilepsy; rare genetic condition	Genetic mutations affecting pyridoxine metabolism	High-dose pyridoxine supplementation; genetic testing for pyridoxine-dependent epilepsy	Infants 0-6 months: 0.1 mg/day. Infants 7-12 months: 0.3 mg/day. Children 1-3 years: 0.5 mg/day. Children 4-8 years: 0.6 mg/day. Children 9-13 years: 1.0 mg/day. Teenagers 14-18 years. Boys: 1.3 mg/day. Girls: 1.2 mg/day. Adult men: 1.3 mg/day. Adult women: 1.3 mg/day. Pregnant women: 1.9 mg/day. Breastfeeding women: 2.0 mg/day
Folic acid (B9)	Important for DNA synthesis; deficiency may impact neurological health	Elevated homocysteine levels; disruption of neurotransmitter levels	Antiepileptic drugs, inadequate dietary intake	Folate supplementation: Address dietary and drug-related factors	Infants 0-6 months: 65 mcg/day. Infants 7-12 months: 80 mcg/day. Children 1-3 years: 150 mcg/day. Children 4-8 years: 200 mcg/day. Children 9-13 years: 300 mcg/day. Teenagers 14-18 years: 400 mcg/day. Adult men and women: 400 mcg/day. Pregnant women: 600 mcg/day. Breastfeeding women: 500 mcg/day
Vitamin B12	Crucial for nervous system functioning; deficiency associated with seizures	Demyelination, altered neurotransmitter levels	Malabsorption, dietary deficiencies	Vitamin B12 supplementation and addressing underlying causes	Infants 0-6 months: 0.4 mcg/day. Infants 7-12 months: 0.5 mcg/day. Children 1-3 years: 0.9 mcg/day. Children 4-8 years: 1.2 mcg/day. Children 9-13 years: 1.8 mcg/day Teenagers 14-18 years: 2.4 mcg/day. Adults: 2.4 mcg/day. Pregnant women: 2.6 mcg/day. Breastfeeding women: 2.8 mcg/day
Vitamin C	Antioxidant with neuroprotective properties; potential impact on glutamate clearance	Lower levels in patients with epilepsy; neuroprotective effects	Dietary deficiency; oxidative stress	Vitamin C supplementation; antioxidant support	Infants 0-6 months: 40 mg/day. Infants 7-12 mons: 50 mg/day. Children 1-3 years: 15 mg/day. Children 4-8 years: 25 mg per/day. Children 9-13 years: 45 mg/day. Teenagers 14-18 years: Boys: 75 mg/day. Girls: 65 mg/day. Adult men: 90 mg/day. Adult women: 75 mg/day. Pregnant women: 85 mg/day. Breastfeeding women: 120 mg/day
Vitamin D	Regulates calcium levels; potential neuroprotective effects	Vitamin D deficiency is associated with increased seizure risk	Limited sun exposure, dietary deficiency	Vitamin D supplementation, sun exposure, and addressing the underlying causes	Infants 0-12 months: 400 IU/day. Children 1-18 years: 600 IU/day. Adults 19-70 years: 600 IU/day. Adults over 70 years: 800 IU/day. Pregnant and breastfeeding women: 600 IU/day
Vitamin E	Lipophilic antioxidant with neuroprotective and anti-inflammatory effects	Neuroprotective effects; anticonvulsant properties	Deficiency symptoms include neurological issues	Vitamin E supplementation; antioxidant support	Infants 0-6 months: 4 mg (6 IU)/ day. Infants 7-12 months: 5 mg/day. Children 1-3 years: 6 mg/day. Children 4-8 years: 7 mg/day. Children 9-13 years: 11 mg/day. Teenagers 14-18 years: 15 mg/day. Adults (including pregnant and breastfeeding women): 15 mg/day
Vitamin K	Role in gamma-carboxylation of brain proteins; potential anticonvulsant effects	Animal studies show anticonvulsant effects; potential role in brain maturation	Vitamin K antagonist exposure; limited dietary intake	Vitamin K supplementation and addressing underlying causes	Infants 0-6 months: 2.0 mcg/day. Infants 7-12 months: 2.5 mcg/day. Children 1-3 years: 30 mcg/day. Children 4-8 years: 55 mcg/day. Children 9-13 years: 60 mcg/day. Teenagers 14-18 years: Boys: 75 mcg/day. Girls: 75 mcg/day. Adults (including pregnant and breastfeeding women): Men: 120 mcg/day. Women: 90 mcg/day