Fasting and epilepsy

• Fasting means not eating for a period of time, and in some cases not drinking as well. There are many reasons why people may choose to fast
• Many people with epilepsy are able to successfully fast, however there is mixed evidence about how safe fasting is for people with epilepsy and there is a need for more research
• Changes to your routine during fasting can increase your risk of having seizures
• It is important to get medical advice before deciding if you are going to fast

Fasting at certain times can be an important part of many religions. Research carried out on people with epilepsy who are fasting during Ramadan has shown a mixture of results. Some research found that people with epilepsy had more seizures when fasting.

Other research found that people with certain seizure types (focal, myoclonic and absence) had less of them during periods of fasting. Another study involving a small number of people with epilepsy found they had fewer seizures while fasting during Ramadan and for a month afterwards. The researchers didn’t report what type of seizures the people had, or if some seizure types were reduced more than others.

Researchers think some of the biggest risks during Ramadan might come from changes in the timings of when you take your epilepsy medicines and having disturbed sleep. If you need to change the times you take your medicine during Ramadan or are likely to get less sleep, it’s a good idea to get advice from your doctor or epilepsy specialist nurse about the best ways to manage these risks.

During Ramadan, Islamic law says that you do not need to fast if it might cause you harm, for example by making a medical condition worse.  Whether this applies to you might depend on several different things such as your age, what type of seizures you have, how well they are managed, whether you have had status epilepticus in the past, and whether you also have other health conditions.

You can talk to your healthcare professional about your personal risks before fasting. They should take into account your health, seizure management, values and beliefs.

If you are having a general anaesthetic, you will need to stop eating and drinking for a set amount of time beforehand. The hospital should give you clear instructions about this.

You can continue to take your epilepsy medicines at their usual time, with a sip of water unless you are told not to. You should carefully follow the instructions you have been given by the hospital where you are due to have your operation.

You can also talk to the person referring you for surgery, or your epilepsy specialist nurse if you have questions about fasting and taking your medicines before surgery.

There’s more information about having a general anaesthetic on the NHS website.

There are several diets that involve periods of fasting (called intermittent fasting). These include:

• Alternate-day fasting – Eat a normal diet one day and fast the next day
• 5:2 fasting – Eat a normal diet for five days a week and fast for two days a week
• Time-restricted eating – Eat normally but only within a specific time frame each day

The evidence about whether these diets help people to lose weight and improve their health is mixed. Some people might find them helpful, but there needs to be more research.  Some animal studies have found that intermittent fasting can have a positive effect on the brain and brain disorders, including seizure control.

However, there aren’t many studies looking at humans to check if intermittent fasting has the same impact in people, and which groups might benefit from it.

Some people feel that missing meals could be a trigger for their seizures. There hasn’t been enough research yet to find out whether this is a risk. If you want to try a diet that involves fasting, you can talk to your healthcare professional about your personal risks. They can help you come to a shared decision that suits your lifestyle, while keeping your risk of seizures as low as possible.

A ketogenic diet is a specialist medical diet that some people use as a treatment option for epilepsy. Although it doesn’t involve fasting, it makes the body think that it’s in a state of starvation or fasting.

Information about ketogenic diets can be found on our website.