Evaluating the serum levels of zinc, copper, magnesium, and 25-hydroxy vitamin D in children with idiopathic drug-resistant epilepsy; a cross-sectional study

BMC Pediatr. 2024 Aug 10;24(1):518. doi: 10.1186/s12887-024-04968-9.

Abstract

Background: Drug-resistant epilepsy is defined as failure of seizure control in spite of using 2 or 3 proper antiepileptic drugs in appropriate time. Mineral elements play important roles in neuronal function; it is believed that mineral deficiency may lead to complications through seizure management. In the present study, serum levels of zinc (Zn), copper (Cu), magnesium (Mg), calcium (Ca), and 25-hydroxy vitamin D (Vit D) in drug-resistant-epilepsy (DRE) patients were evaluated and compared with the controlled patients.

Methods: In this cross-sectional study, epileptic patients were included and categorized into two groups of DRE and well-controlled patients. Patients' serum samples were analysed to evaluate Zn, Cu, Mg, Ca, and Vit D levels. The primary objective was comparison of serum levels of different trace elements between the groups.

Results: Sixty-four epileptic children including 33 DRE and 31 well-controlled children entered the study. The DRE children showed a significantly earlier onset of disease compared to the other group (p = 0.014). Comparing the frequency of developmental delay between the groups, the results showed this complication was significantly more frequent in the DRE group (p < 0.001). Concerning serum elements, the results showed a significantly higher concentration of Zn in the well-controlled group than the DRE group (p = 0.007). On the other hand, no significant differences were observed between the groups regarding the means of Vit D, Ca, Cu, and Mg levels (p > 0.05).

Conclusion: The results of the present study delineated that drug-resistant epilepsy patients had earlier onset of disease and were at higher risk of neurodevelopmental delay compared with well-controlled-epilepsy patients. A significant lower serum levels of Zn were also observed in drug-resistant-epilepsy patients. This finding may suggest the role of zinc supplementation in help to better control of drug-resistant seizures, as well as, the importance of serum zinc monitoring in epileptic patients.

Keywords: Child; Drug-resistant epilepsy; Seizures; Trace element.

MeSH terms

  • Adolescent
  • Anticonvulsants / therapeutic use
  • Calcium / blood
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Copper* / blood
  • Cross-Sectional Studies
  • Drug Resistant Epilepsy* / blood
  • Drug Resistant Epilepsy* / drug therapy
  • Drug Resistant Epilepsy* / etiology
  • Female
  • Humans
  • Infant
  • Magnesium* / blood
  • Male
  • Vitamin D* / analogs & derivatives
  • Vitamin D* / blood
  • Zinc* / blood

Substances

  • Vitamin D
  • Copper
  • Zinc
  • Magnesium
  • 25-hydroxyvitamin D
  • Anticonvulsants
  • Calcium