Oxidative stress and antioxidants in epilepsy

In the present study, erythrocyte membrane lipid peroxidation, the percentage hemolysis, erythrocyte enzymes superoxide dismutase (SOD), glutathione peroxidase (GP), glutathione reductase (GR), catalase, and plasma vitamin C, vitamin E, vitamin A and ceruloplasmin activities and concentrations were determined in 29 epileptic patients and 50 normal controls. Ten patients who were treated with phenobarbital and who did not get convulsions for 1 year were considered for followup. Lipid peroxidation and percentage hemolysis in patients with epilepsy was significantly higher when compared to controls. Moreover, plasma ceruloplasmin concentrations were also markedly increased in these cases. Erythrocyte GR and plasma vitamin C and A concentrations were significantly lower in epileptics when compared to controls. In the followup patients, the erythrocyte GR was significantly higher than their pre-treated condition. Furthermore, the plasma vitamin A, E and C concentrations have attained the normal range. This study indicates that the antioxidant status in blood of epileptic patients which was low compared to controls, improved after treatment, suggesting that free radicals may be implicated in epilepsy.

Effect of antiepileptic drugs on erythrocyte osmotic fragility and lipid peroxidation

Epileptic children receiving antiepileptics were studied to investigate the effect of carbamazepine and phenobarbital therapy on erythrocyte osmotic fragility and lipid peroxidation. Significant differences between the two groups were observed in erythrocyte osmotic fragility. In addition, there was a significant increase in erythrocyte malondialdehyde release in the epileptic group compared to controls. It is suggested that the use of antioxidants in addition to antiepileptic drugs may be beneficial.

Randomized, double-blind, placebo-controlled, clinical trial of D-alpha-tocopherol (vitamin E) as add-on therapy in uncontrolled epilepsy

In a double-blind, cross-over trial, vitamin E, and placebo were compared as add-on therapy in 43 patients with uncontrolled epilepsy. The study consisted of a 3-month baseline period followed by two treatment phases of vitamin E or placebo with cross-over to the second phase after 3 months. No significant side effects were noted during the study. Mean seizure frequency in the baseline period was 15.9 +/- 10.5 as compared with 11.8 +/- 10.9 during the placebo phase and 13.7 +/- 11.1 during the vitamin E phase. No significant change in seizure frequency was observed with vitamin E as compared with placebo (p > 0.1). Similar observation was noted in subgroups with generalized seizures (n = 25), partial with secondarily generalized seizures (n = 11), or complex partial seizures (CPS) (n = 7). This study did not corroborate the earlier claims of therapeutic efficacy of vitamin E as add-on therapy in refractory epilepsy in adults.

Vitamin E status of US children

Data from several national surveys consistently show that American children have lower than recommended intakes of vitamin E, which is reflected in lower than average serum levels. Reduction in dietary fat can further exacerbate the low vitamin E status of children. The consequences of low vitamin E intake may include impaired immune responses, as seen in a study of over 500 Canadian children. Low vitamin E status has been correlated with increased risk of atherosclerosis and cardiovascular disease, cancer, cataract and impaired immune responses in adult populations. Since early signs of chronic degenerative diseases of aging have been seen in autopsies of children, efforts should be made to ensure that prolonged low intakes of vitamin E are avoided in children as well as adults.