The value of D-alpha-tocopheryl acetate (Vitamin E 400 IU/day) as an adjunct therapy for drug resistant epilepsy is reported from The Hospital for Sick Children and the University of Toronto Faculty of Medicine, Canada. In a randomized, double-blind, placebo-controlled trial, 10 of 12 children aged 6-17 years showed a greater than 60% reduction in seizure frequency whereas none in the control group showed a significant change. One-half of the responders had concomitant EEG improvements. The study period was 9 months: 3 mo pre-trial, 3 mo double-blind, and 3 mo open-label trial in which patients receiving placebo initially changed to Vitamin E as their own controls. The majority had generalized tonic-clonic seizures and anticonvulsant drug levels showed no significant change during treatment with Vitamin E. Plasma Vitamin E levels increased from 5 to 37 mcM during the treatment phase, the variability dependent on body size. Improvement in seizure control was similar in the open-label phase and no clinically significant alterations of blood counts, SGOT, alkaline phosphatase, and amylase were noted. 
COMMENT. These authors and others have reported reduced plasma levels of Vitamin E in children taking antiepileptic drugs. Hyperbaric oxygen-induced seizures in rats are prevented by prior administration of Vitamin E. . The clinical trial reported here and a previous uncontrolled study support the experimental findings in animals that Vitamin E may inhibit the effects of oxidation in brain tissue and act as a membrane stabilizer in epileptic cerebral cortex. Further trials of this adjunctive treatment for refractory epilepsies are certainly warranted.