Role of Magnesium Supplementation in Children with West Syndrome: A Randomized Controlled Clinical Trial
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Studying Brain Function in Children Using Magnetoencephalography
Published on: April 8, 2019
Vijay Kumar Yadav1, Amrita Amrita1, Sunita Yadav2
1Department of Pediatrics, M.R.A. Medical College, Ambedkar Nagar, UP, India.
Insights
Magnesium supplementation showed promise in improving electroencephalogram results for children with West syndrome. Clinical response was better in patients with normal initial serum magnesium levels.
Area of Science:
- Neurology
- Pediatrics
- Epileptology
Background:
- West syndrome is a severe infant epileptic encephalopathy characterized by spasms, developmental regression, and hypsarrhythmia.
- Current antiepileptic drugs offer limited efficacy in controlling spasms, necessitating exploration of alternative treatments.
- There is a need for novel therapeutic strategies to manage this debilitating condition.
Purpose of the Study:
- To investigate the efficacy of magnesium supplementation as an adjunct therapy for West syndrome.
- To evaluate the impact of magnesium on seizure control, neurodevelopmental outcomes, and electroencephalogram patterns.
- To explore potential predictors of treatment response in children with West syndrome.
Main Methods:
- An open-label, randomized controlled trial involving 52 newly diagnosed children (3 months to 5 years) with West syndrome.
- Participants were randomized into an intervention group (magnesium sulfate + standard care) and a control group (standard care only).
- Standard care included adrenocorticotropic hormone and antiepileptic drugs; follow-up was three months with per-protocol analysis.
Main Results:
- No significant differences in seizure control or neurodevelopmental outcomes between groups.
- Significant improvement in electroencephalogram (EEG) findings in the magnesium intervention group compared to the control group.
- A notably better clinical response was observed in the intervention group among patients with normal initial serum magnesium levels (p=0.003).
Conclusions:
- Magnesium supplementation may offer benefits in managing West syndrome, particularly regarding EEG improvements.
- The findings suggest that baseline serum magnesium levels could influence treatment response.
- Further research is warranted to confirm the role of magnesium in West syndrome management.
Objectives:
West syndrome is a severe epileptic encephalopathy of young age. It is characterized by a clinico-electrical triad of infantile epileptic spasms, regression or arrest of psychomotor development, and hypsarrhythmia. In the last two decades, the large progress in the development of newer antiepileptic drugs has allowed us to have a vast choice of treatment options to control spasms, although they often fail to do so. Thus, there is a need to explore other treatment options.
Materials & Methods:
Subjects in this open-labelled randomized control trial were included newly diagnosed children of age between 3 months and 5 years of both genders. A total of 52 children were recruited and randomized into two groups: an intervention group (n=30) and a non-intervention group (n=22). Magnesium sulphate was provided for the intervention group but not for the non-intervention one. Both groups received the rest of the treatments, including adrenocorticotropic hormone and antiepileptic drugs. The follow-up period was three months, at the end of which a per-protocol analysis was performed.
Results:
There was no significant difference in seizure control and neurodevelopmental outcome between both groups, but electroencephalogram significantly improved in the intervention group compared to the control. Also, the clinical response was better in patients with normal initial serum magnesium levels in the intervention group (p=0.003) than in other patients.
Conclusion:
Magnesium supplementation may be helpful in children with West syndrome.
