dawnmedDawnMed Journal of Medical ScienceISVolume 1, Issue 1MultidisciplinaryEnglish2025NNY2025049Neurology Seizure Control During Ramadan Fasting in Epilepsy: A Systematic Review of Clinical Evidence.EnglishY16Ahmed M.Al-Harby¹²EnglishNFatimahAl-salemi¹EnglishYKhalidNgah²EnglishYSaraElsahmy¹EnglishYNasser Y.Sofian²EnglishYBackground: Epilepsy affects over 50 million people globally, with a substantial number residing in Muslim-majority countries where Ramadan fasting is widely observed. Ramadan fasting involves prolonged daily abstinence from food, drink, and oral medications, potentially impacting seizure control in patients with epilepsy due to changes in medication adherence, sleep patterns, and metabolic status. Aim: This systematic review synthesizes clinical evidence regarding the effects of Ramadan fasting on seizure frequency and control.Methods: A systematic search of PubMed, Scopus, Web of Science, Embase, and the Cochrane Library was conducted on May 10, 2025, identifying prospective observational studies assessing seizure control during Ramadan fasting. Five studies encompassing 672 patients were included. Quality was appraised using the Newcastle-Ottawa Scale. Due to heterogeneity, findings were narratively synthesized.Results: The evidence reveals mixed effects of Ramadan fasting on seizure control. Some studies report a significant reduction in focal and myoclonic seizures during and after Ramadan, potentially linked to favorable metabolic adaptations and improved medication adherence. Conversely, other studies observed increased seizure frequency associated with altered antiepileptic drug regimens and sleep disturbances. Medication adherence was variable but critical to seizure outcomes. Quality of life measures showed limited improvement during fasting, reflecting psychosocial stress and physiological challenges.Conclusion: Ramadan fasting can be safe for well-controlled epilepsy patients with stable medication regimens, but individualized management and close monitoring are essential. Metabolic changes, medication scheduling, and sleep hygiene must be carefully managed to minimize seizure risk. Further large-scale prospective studies are needed to optimize clinical guidelines balancing religious observance with patient safety.EnglishEpilepsy; Ramadan fasting; seizure control; antiepileptic drugs.https://www.dawnmed.com.sa/abstract?id=1References1619World Health Organization. Epilepsy. 2023. [https://www.who.int/news-room/fact-sheets/detail/epilepsy]Al-Asmi A, Al-Adawi S, Murthy V, et al. Epilepsy in Oman: A review of the literature. 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