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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. |