BACKGROUND During Ramadan, the ninth month of the lunar Islamic calendar, adult Muslims are obliged to fast, which involves refraining from taking any food, beverages, or oral medications from dawn to sunset. Fasting's effect on seizure control is not fully understood, and a few observational studies have provided inconclusive results. This study aimed to investigate the effect of fasting during Ramadan on seizure control and quality of life in adult patients with epilepsy. METHODS This was a prospective observational study over a 3-month period (one month before fasting, the fasting month, and one month after fasting). We recruited adult patients with active epilepsy who were able to fast during the month of Ramadan. The primary outcome measures were as follows: 1) seizure control and 2) quality of life score using the Arabic version of the Ferrans and Powers Quality of Life Index (QLI). Changes in anticonvulsant medications were not allowed during the study period. We used a seizure log provided to participants to record the number of seizures during the 3-month period. Quality of life was scored at the end of each month of the study period. RESULTS Thirty-seven patients were studied (59% males). The mean age was 30 years (range, 14-51 years), and mean age at epilepsy onset was 13 years (range, 0.5-35 years). On average, patients were on three antiepileptic medications at baseline (range: 2-5). A total of 1576 seizures were reported during the 3-month follow-up, where seizures prior to fasting represented 35.5% of all seizures. Multilinear regression analysis revealed a significant decline of seizures by 21% during the fasting month compared with baseline (adjusted coefficient = 0.79, p < 0.01, 95% confidence interval (CI); 0.61-0.98, R2 = 0.81) and by 29% during post fasting compared with baseline (adjusted coefficient = 0.71, p < 0.01, 95% CI; 0.53-0.90, R2 = 0.79). No significant change was found in the QLI scores calculated during the three months of the study period. CONCLUSION Fasting during Ramadan might have a positive impact on seizure control in patients with epilepsy, which continued during the month following fasting, whereas the quality of life scores were not affected by fasting.

中文翻译：

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斋月禁食对癫痫患者癫痫发作控制和生活质量的影响

背景在斋月期间，即伊斯兰教历的第九个月，成年穆斯林必须禁食，这包括从黎明到日落不吃任何食物、饮料或口服药物。禁食对癫痫控制的影响尚不完全清楚，一些观察性研究提供了不确定的结果。本研究旨在调查斋月期间禁食对成年癫痫患者癫痫发作控制和生活质量的影响。方法 这是一项为期 3 个月（禁食前一个月、禁食月和禁食后一个月）的前瞻性观察研究。我们招募了能够在斋月期间禁食的成年活动性癫痫患者。主要结局指标如下：1) 癫痫控制和 2) 生活质量评分，使用阿拉伯语版本的 Ferrans 和 Powers 生活质量指数 (QLI)。在研究期间不允许改变抗惊厥药物。我们使用提供给参与者的癫痫发作日志来记录 3 个月期间的癫痫发作次数。在研究期间的每个月末对生活质量进行评分。结果 研究了 37 名患者（59% 为男性）。平均年龄为 30 岁（范围，14-51 岁），癫痫发作的平均年龄为 13 岁（范围，0.5-35 岁）。平均而言，患者在基线时服用了三种抗癫痫药物（范围：2-5）。在 3 个月的随访期间总共报告了 1576 次癫痫发作，其中禁食前的癫痫发作占所有癫痫发作的 35.5%。多元线性回归分析显示，与基线相比，禁食月份的癫痫发作显着减少了 21%（调整后的系数 = 0.79，p < 0.01，95% 置信区间 (CI)；0.61-0.98，R2 = 0.81）并且在禁食期间减少了 29%禁食后与基线相比（调整系数 = 0.71，p < 0.01，95% CI；0.53-0.90，R2 = 0.79）。在研究期间的三个月内计算的 QLI 分数没有发现显着变化。结论斋月期间禁食可能对癫痫患者的癫痫控制产生积极影响，这种影响在禁食后的一个月内持续存在，而生活质量评分不受禁食的影响。81) 和禁食后与基线相比增加 29%（调整系数 = 0.71，p < 0.01，95% CI；0.53-0.90，R2 = 0.79）。在研究期间的三个月内计算的 QLI 分数没有发现显着变化。结论斋月期间禁食可能对癫痫患者的癫痫控制产生积极影响，这种影响在禁食后的一个月内持续存在，而生活质量评分不受禁食的影响。81) 和禁食后与基线相比增加 29%（调整系数 = 0.71，p < 0.01，95% CI；0.53-0.90，R2 = 0.79）。在研究期间的三个月内计算的 QLI 分数没有发现显着变化。结论斋月期间禁食可能对癫痫患者的癫痫控制产生积极影响，这种影响在禁食后的一个月内持续存在，而生活质量评分不受禁食的影响。