RT Journal Article
      AU Ahmed M. Al-Harby¹², Fatimah Al-salemi¹, Khalid Ngah², Sara Elsahmy¹, Nasser Y. Sofian²
      TI Seizure Control During Ramadan Fasting in Epilepsy: A Systematic Review of Clinical Evidence.
      T2 Neom Journal of Medical Science
      DO  
      VL Volume 1, Issue 1 
      SP 1
      EP 6
      PY 2025
      AB <p style="text-align:justify"><span style="font-size:12pt"><span style="line-height:150%"><span style="font-family:"Times New Roman",serif"><b>Background: </b><a name="_Hlk197970126">Epilepsy affects over 50 million people globally, with a substantial number residing in Muslim-majority countries where Ramadan fasting is widely observed. Ramadan fasting involves prolonged daily abstinence from food, drink, and oral medications, potentially impacting seizure control in patients with epilepsy due to changes in medication adherence, sleep patterns, and metabolic status. </a></span></span></span></p><p style="text-align:justify"><span style="font-size:12pt"><span style="line-height:150%"><span style="font-family:"Times New Roman",serif"><b>Aim:</b> This systematic review synthesizes clinical evidence regarding the effects of Ramadan fasting on seizure frequency and control.</span></span></span></p><p style="text-align:justify"><span style="font-size:11pt"><span style="line-height:150%"><span style="font-family:"Arial",sans-serif"><b><span lang="EN" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:"Times New Roman",serif">Methods: </span></span></span></b><span lang="EN" style="font-size:12.0pt"><span style="line-height:150%"><span style="font-family:"Times New Roman",serif">A systematic search of PubMed, Scopus, Web of Science, Embase, and the Cochrane Library was conducted on May 10, 2025, identifying prospective observational studies assessing seizure control during Ramadan fasting. Five studies encompassing 672 patients were included. Quality was appraised using the Newcastle-Ottawa Scale. Due to heterogeneity, findings were narratively synthesized.</span></span></span></span></span></span></p><p style="text-align:justify"><span style="font-size:12pt"><span style="line-height:150%"><span style="font-family:"Times New Roman",serif"><b>Results: </b>The evidence reveals mixed effects of Ramadan fasting on seizure control. Some studies report a significant reduction in focal and myoclonic seizures during and after Ramadan, potentially linked to favorable metabolic adaptations and improved medication adherence. Conversely, other studies observed increased seizure frequency associated with altered antiepileptic drug regimens and sleep disturbances. Medication adherence was variable but critical to seizure outcomes. Quality of life measures showed limited improvement during fasting, reflecting psychosocial stress and physiological challenges.</span></span></span></p><p style="text-align:justify"><span style="font-size:12pt"><span style="line-height:150%"><span style="font-family:"Times New Roman",serif"><b>Conclusion</b>: Ramadan fasting can be safe for well-controlled epilepsy patients with stable medication regimens, but individualized management and close monitoring are essential. Metabolic changes, medication scheduling, and sleep hygiene must be carefully managed to minimize seizure risk. Further large-scale prospective studies are needed to optimize clinical guidelines balancing religious observance with patient safety.</span></span></span></p>
      KW: Epilepsy; Ramadan fasting; seizure control; antiepileptic drugs.
      UL https://dawnmed.com.sa/../abstract?article_id=1