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Published on: September 1, 2023
Serum Trace Elements in Children with Well-Controlled and Drug Refractory Epilepsy Compared to Controls: An
Biswaroop Chakrabarty1, Ankush Singh Dogra1, G S Toteja2
1Child Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India.
Insights
Serum trace element levels, including selenium and copper, are altered in children with epilepsy, particularly in drug-refractory cases. Monitoring these micronutrients may benefit epilepsy management.
Area of Science:
- Pediatric Neurology
- Clinical Chemistry
- Nutritional Science
Background:
- Trace elements are increasingly recognized for their role in epilepsy pathogenesis.
- Previous studies indicate altered serum trace element levels in children with epilepsy.
Purpose of the Study:
- To quantify serum trace element levels in children with well-controlled and drug-refractory epilepsy.
- To compare these levels against age and gender-matched controls.
Main Methods:
- Serum selenium, copper, zinc, and iron were analyzed in 106 children with epilepsy (55 drug-refractory, 51 well-controlled) and 52 controls.
- Participants were children aged 2-12 years from a North Indian tertiary care hospital.
Main Results:
- Serum selenium and copper were significantly lower in children with epilepsy compared to controls.
- This reduction was more pronounced in the drug-refractory epilepsy group.
- Drug-refractory epilepsy cases also showed significantly reduced serum iron levels.
Conclusions:
- Serum trace element levels are significantly altered in children with epilepsy, with notable differences in the drug-refractory subgroup.
- Monitoring trace elements in epileptic children is recommended.
- Investigating the therapeutic potential of addressing micronutrient imbalances in drug-refractory epilepsy warrants further study.
Background:
Trace elements have been implicated in pathogenesis of epilepsy. Studies till date have shown altered levels of serum trace elements in children with epilepsy.
Objective:
The objective of the current was to estimate serum levels of trace elements in children with well-controlled and drug refractory epilepsy and compare it with controls.
Methodology:
In a tertiary care teaching hospital of North India, serum selenium, copper, zinc, and iron were estimated in well-controlled and drug refractory epileptic children aged 2-12 years and compared with age and gender matched controls.
Results:
A total of 106 children with epilepsy (55 drug refractory and 51 well controlled) and 52 age and gender matched controls were included in the study. Serum selenium and copper were significantly decreased in cases compared to controls. After classifying epilepsy into well-controlled and drug refractory cases, only in the latter the significant difference for serum selenium and copper levels remained compared to controls. Additionally, in the drug refractory cases, serum iron levels were significantly reduced compared to controls.
Conclusions:
Serum trace elements are altered in children with epilepsy (more so in the drug refractory group) compared to controls. Monitoring of serum trace elements in children with epilepsy should be considered. Up to one-third of epilepsy is drug refractory of which only another third are amenable to surgery. It is worth investigating the therapeutic potential of altered micronutrient status in these patients.
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