الفهرس 
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Abstract
Epilepsy is a very common neurological disease in childhood, affecting 0.5-1
% of children younger than 16 years. Among those with epilepsy 22-30 % has drug
resistant epilepsy. Nowadays researches focus on the role of vitamins and minerals
homeostasis as adjunctive therapy among epileptic children. Regarding vitamin D and
magnesium; vitamin D deficiency and hypomagnesaemia are highly prevalent among
children with epilepsy. Many studies support the relation between vitamin D
deficiency and seizure severity. Vitamin D has a direct effect in the brain, through
vitamin D specific receptors in neurons and glial cells throughout the brain, in spinal
cord and in the peripheral nervous system, that helps in reduction of neuronal
hyperexcitability and incidence of seizure. Vitamin D deficiency has an adverse effect
on seizure; it tends to increase seizure frequency. Magnesium is the 2nd most
common intracellular cation in the body after potassium. Mg has a membrane
stabilizing effects; it acts as a competitive antagonist to N-methyl-D-aspartate
glutamate receptors which in turn decrease neuronal excitability. Hypomagnesaemia
can increase seizure activity and itself can cause seizure with more severe deficiency.
The aim of this work was to measure serum levels of vitamin D and
magnesium in epileptic children; and to study any beneficial effects of vitamin D and
magnesium supplementation whenever deficient in their management.
This study was conducted on 30 children with idiopathic epilepsy (patient
group). They were subdivided into 15 children with controlled epilepsy and 15
children with uncontrolled epilepsy. Fifteen clinically healthy children served as a
control group. Detailed history was taken about seizure; onset, type, its duration,
number of attacks (the patient considered well controlled, if seizure free over the past
6 months), type and duration of antiepileptic drugs used. Detailed neurological
examination and manifestations of vitamin D and mg deficiency were assessed.
Serum levels of vitamin D (25(OH) D) and Mg were assessed in both groups.
Epileptic children who had deficiency, controlled and uncontrolled, were
supplemented with oral vitamin D (6000IU/Day for 8 weeks followed by 600 IU/Day
as a daily maintenance dose), and oral Mg (5mg/kg/Day for 3 months) with their
regular antiepileptic drugs. Uncontrolled epileptics followed up during the period of
treatment, for 3 months, to detect if vitamin D and oral Mg had an impact on seizures
frequency.
All children aged from 3-15 years, median age was 8 years. Age and sex
showed no significant statistical differences between the three groups (p-values 0.838
& 0.53 respectively). Vitamin D and Mg serum levels were significantly lower in
epileptic children than the control group (p-value 0.0001). Vitamin D and Mg serum
levels were significantly lower in uncontrolled than controlled children (p-value
0.0001; Mean±SD for vitamin D = 22.02±4.36 ng/ml and 42.03±18.14 ng/ml in order,
Mean±SD for Mg = 1.087±0.32 mg/dl, 1.61±0.2 mg/dl in order). Manifestations of
vitamin D and Mg deficiency were significantly present in uncontrolled epileptics
compared to controlled epileptics (p-value 0.001 & 0.0025). Vitamin D and Mg serum
levels showed a highly significant correlation to mean number of seizures/month
before treatment (p-value 0.001 & 0.0001 respectively), with inverse correlation (r = -
0.786 & - 0.873 respectively). Uncontrolled epileptics with lower vitamin D and Mg
serum levels had much more seizures′ attacks/month.