Arguments for a Relationship Between Malnutrition and Epilepsy

Abstract

Malnutrition and epilepsy are two major health issues, essentially in developing countries. Malnutrition is responsible for moderate to severe disabilities. Several studies performed on animal models or humans highlight the possible adverse effects of malnutrition on the occurrence of seizures or epilepsy. Low protein diet and certain micronutrient deficiencies as vitamins, trace-elements, or electrolytes are involved. In contrast, a ketogenic diet (high fat and low carbohydrate) can be used in the treatment of severe epilepsy. In developing countries, there are a lot of beliefs around epilepsy (origin, contagiousness of epilepsy, and so on). Sociocultural attitudes as food taboos and social stigma can be responsible for a negative impact on the nutritional status of people with epilepsy. Antiepileptic drugs or traditional treatments can also be responsible for malnutrition. A link between malnutrition and epilepsy has been suspected for many years. But scientific data in humans are scarce. Two different hypotheses can be put forward: malnutrition predisposing to seizure/epilepsy or epilepsy predisposing to malnutrition. The mechanisms implicated, here are as various as decrease of seizure threshold, altered neurotransmission, or anorexia induced by antiepileptic drugs. A better understanding of these interactions is necessary. In the mean time, malnutrition has to be prevented and treated.