الفهرس 
DefinitionOnly 14 pages are availabe for public view
 |  | from | 98 |  |  |
| | | from | 98 | | |
Abstract
Seizure disorder is one of the most common neurological diseases in children and occurs at least one time in 4-10% of children in the first 16 years of life. Epilepsy is a disorder of brain electrical activity that may lead to recurrent seizures. The type of seizure depends on the part of the brain involved, and various causes can lead to seizures.
Epilepsy begins in childhood in more than half of the cases. Approximately 50 million people in the world have epilepsy, up to one -third of who continue to have seizures despite appropriate drug treatment. Epilepsy is a common disorder, the highest incidence occurs in childhood, with a second peak of increased incidence occur in elderly.
Patients presenting with epileptic seizures may have a large number of potential underlying causes. However, the situation is slightly complicated in that the term epilepsy is on occasion also used as part of the diagnosis.
Different mineral elements are critical for normal functioning of the central nervous system, and several studies have demonstrated that changes in different electrolytes of the body, such as sodium, potassium, magnesium, and the trace elements such as copper (Cu) and zinc (Zn) subsequently are effective on the incidence of convulsions and epilepsy.
The aim of the current study was to assess the serum Zinc, Copper, Iron and Selenium levels and clinical importance in epileptic children.
The present study was carried out on 60 epileptic children of both sexes, aged diagnosed and classified according to ILAE 2017. Twenty clinically healthy age and sex matched children were taken as a control group. The patients were randomly selected from those attending the outpatient pediatric neurology clinic and those admitted in pediatric department in Menoufia University Hospitals during period from
Summary
118
September 2018 to April 2019.
Inclusion criteria:
Epileptic children diagnosed according to ILAE criteria (2017).
Age from 1 year up to 15 year.
Both sexes
Exclusion criteria:
Clinical symptoms of zinc, copper, iron and selenium deficiencies.
Anemia and pallor as anemia are one of the symptoms of Zn and Cu deficiency (excluded by CBC).
Patients and control children were grouped into 3 groups as follow:
group I (Intractable epilepsy group): included 30 children with intractable epilepsy they developed at least 1 seizure or more per month in a 6-months period despite being treated with at least 2 antiepileptic drugs.
group II (controlled epilepsy group): included 30 patients with controlled epilepsy.
group III (control group): included 20 clinically healthy matched for age and sex children.
All children included in the study were subjected to the following:
- Detailed history taking:
- Thorough clinical examination
- Investigations: The following investigation were performed:
- Complete blood count (CBC)
- Kidney functions
- Liver function test
- Measurement of serum zinc, copper, iron and selenium levels
Summary
119
Results of the current study could be summarized as follow:
There were no statistically significant differences between patients and controls groups regarding age, sex, family history of epilepsy, positive consanguinity, positive perinatal insult, delayed milestone and types of seizures. However, there was a statistically significant difference between patients and controls group regarding neonatal seizures, power, tone, reflexes, cranial nerve palsy, speech and mentality.
Intractable epilepsy patients had low serum zinc mean levels (53.3%, with mean 63.47±17.06 μg/dl) compared to those with controlled epilepsy (76.67%, with mean 81.6±16.79 μg/dl). Both epileptic groups had significantly lower zinc levels compared to the healthy controls (0.00%, with mean 81.6 ± 16.79 μg/dl).
Zn deficient patients had no significant differences regarding age, sex, family history of epilepsy, perinatal insult, tone, and mentality, when compared with normal Zn level patients. However, inexplicably a significantly higher percentage of epileptic patients with normal for Zn levels with had positive consanguinity in compared to those with low serum Zn levels.
Intractable epilepsy patients had significantly low serum Cu level (60%, with mean 56.15±17.41 μg/dl) compared to those with controlled epilepsy (73.33%, with mean61.77±22.16 μg/dl). Both epileptic groups had significantly lower zinc levels compared to the controls (15%, with mean 71.7 ± 13.74 μg/dl).
Cu deficient patients had no significant differences regarding sex, consanguinity and Mentality when compared with normal Cu level patients. However, a significant difference was observed regarding age, family history of epilepsy, perinatal insult, power, tone, and reflexes
Summary
111
when compared with normal Cu level patients in the two epileptic groups together.
Intractable epilepsy patients had significantly low serum selenium level (53.33% with mean 35.40±11.91 μg/d) compared to those with controlled epilepsy (60%, with mean 58.16±7.12 μg/d) Both epileptic groups had significantly lower selenium levels compared to the controls (0.00%, with mean 142.55±36.14 μg/d).
Selenium deficient patients had significant differences regarding family history of epilepsy, perinatal insults, tone and tendon reflexes when compared with normal selenium level patients. However, no significant differences were observed regarding age, sex and consanguinity when compared with normal selenium level patients in the two epileptic groups together.
Intractable epilepsy patients had significantly low serum iron levels (56.67%, with mean 0.75±0.015 μg/ml) compared to those with controlled epilepsy (66.67%, with mean 0.75±0.015 μg/ml). Both epileptic groups had significantly lower iron levels compared to the controls (10%, with mean1.46±0.35 μg/ml).
Iron deficient patients had significantly differences regarding age, sex, and power when compared with normal iron level patients. However, iron deficient patients hadn’t significantly differenced regarding family history of epilepsy, consanguinity, perinatal insult, tone, reflexes and mentality when compared with normal iron level patients in the two epileptic groups.