Omega-3 fatty acid (FA) supplements (lg EPA and 0.7g DHA daily) were used in the treatment of 58 patients with refractory epilepsy, in a 12-week double-blind, placebo-controlled trial conducted by researchers at the UCL Institute of Neurology, London, UK. In the first 6 weeks of treatment, a 50% reduction in seizures was obtained in 5 of 29 supplemented patients whereas none (0/27) showed benefit with placebo (P = 0.087). In the second 6 weeks, this apparent initial trend toward significant difference in seizure control was not sustained: 4/30 in the supplemented group and 5/27 in placebo group showed reduction in seizure frequency. The need for intermittent therapy with diazepam did not differ between the two groups. Status epilepticus occurred in one patient in each group. FA supplements produced an expected increase in plasma EPA and DHA concentrations and a reciprocal fall in omega-6 arachidonic and linoleic acid concentrations. Antiepileptic drug levels were unaffected. [1]

COMMENT. Experimental studies in animals have shown that EPA and DHA as well as omega-6 FA will raise seizure thresholds, and omega-3 FA will lower plasma inflammatory mediators, which may lead to reduction in seizure susceptibility [2]. In a recent report of the benefits of fatty acid supplements in children with reading disabilities and ADHD, a combination of omega-3 and -6 FA was recommended (Ped Neur Briefs May 2005;19:33-34) [3]. Future trials of FA supplements in patients with refractory epilepsy should perhaps include both omega-3 and -6 FA.