Correlation of serum magnesium levels in febrile convulsions in children: a cross sectional comparative study

Shalini Addlur; Rohit Khandelwal; Shivalingappa B. Mangajjera; Leeni Mehta

doi:10.18203/2349-3291.ijcp20211077

Authors

Shalini Addlur Junior Consultant, Columbia Asia Hospital, Bangalore, Karnataka, India http://orcid.org/0000-0002-9142-3847
Rohit Khandelwal Department of Paediatrics, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India
Shivalingappa B. Mangajjera Department of Paediatrics, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India
Leeni Mehta Consultant Physician, Apollo Group of Hospitals, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20211077

Keywords:

Serum magnesium, Febrile convulsions, Blood glucose

Abstract

Background: Febrile convulsions is one of the most common type of seizures seen in children. It has been suggested that low serum magnesium (Mg) has occasionally been associated with epilepsy. A positive correlation of the hypomagnesemia with the severity of epilepsy was also found. The present study aimed to estimate the levels of serum magnesium in children with febrile convulsions and to compare serum magnesium levels with normal children.

Methods: Fifty patients who were eligible after screening for inclusion and exclusion criteria were included in the study group after a signed written informed consent and 50 controls were also taken. A detailed history, clinical examination and these investigations were done – complete blood count (CBC) (Hb, DC and ESR), serum calcium, serum magnesium, serum electrolytes, random blood sugar and cerebrospinal fluid (CSF) analysis.

Results: The serum magnesium level was normal in 45 patients (90%) with febrile convulsions, low levels in 4 cases (8%) and high levels seen in 1 case (2%). Serum magnesium levels were normal in all 50 controls. In this study, the serum magnesium levels has got no correlation in patients with febrile convulsion. So, routine magnesium supplementation need not be prescribed in normal subjects to prevent febrile convulsions.

Conclusions: Routine measurement of serum levels of Mg, glucose and calcium are warranted in subject with febrile convulsions. However, large prospective studies are further required in future to establish the correlation of serum Mg and febrile convulsions so that a standard guidelines can be set up which could be followed universally.

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Author Biography

Shalini Addlur, Junior Consultant, Columbia Asia Hospital, Bangalore, Karnataka, India

ASSOCIATE PROFESSOR,
DEPARTMENT OF PAEDIATRICS,
VYDEHI INSTITUTE OF MEDICAL SCIENCES AND RESEARCH CENTRE,
BANGALORE,
KARNATAKA.
INDIA.

References

Michael V. Nelson Textbook of Pediatrics. 17th ed. Philadelphia: WB Saunders. 2004.

Garty BZ, Olomucki R, Lerman-Sagie T, Nitzan M. Cerebrospinal fluid zinc concentrations in febrile convulsions. Arch Dis Child. 1995;73(4):338-41.

Hamed SA, Abdellah MM. Trace elements and electrolytes homeostasis and their relation to antioxidant enzyme activity in brain hyperexcitability of epileptic patients. J Pharmacol Sci. 2004;96(4):349-59.

Benga I, Baltescu V, Tilinca R, Pavel O, Ghiran V, Muschevici D, et al. Plasma and cerebrospinal fluid concentrations of magnesium in epileptic children. J Neurol Sci. 1985;67(1):29-34.

Chhaparwal BC, Kohli G, Pohowalla JN, Singh SD. Magnesium levels in serum and in C.S.F. in febrile convulsions in infants and children. Indian J Pediatr. 1971;38(280):241-5.

Mishra OP, Prasad R, Singh AR, Das BK, Upadhyay RS, Singh TB. Cerebrospinal fluid zinc, magnesium, copper and gamma- aminobutyric acid levels in febrile seizures. J Pediatr Neurol. 2007;5:39-44.

Ahmad T, Zarichehr V, Ali TS, Mahbobeh KS, Abbas MS. Assessment of the relation between serum zinc & magnesium levels in children with febrile convulsion. Iranian J Pathol. 2009;4(4):157-60.

Papierkowski A, Mroczkowska-Juchkiewicz A, Pawłowska-Kamieniak A, Pasternak K. Magnesium and zinc levels in blood serum and cerebrospinal fluid in children with febrile convulsions. Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego. 1999;6(33):138-40.

Rutter N, Smales OR. Calcium, magnesium, and glucose levels in blood and CSF of children with febrile convulsions. Arch Dis Child. 1976;51(2):141-3.

Shah QA, Jamil AA, Gupta VP, Kabiraj MM, Shah AH. Changes in Serum Electrolytes in Childhood Epilepsy: A Hospital Based Prospective. Greenwich J Sci Tech. 2001;2:18-27.

Govil MK, Mangal BD, Alam SM, Mahendru RK, Srivastava DK, Mudgal JC. Serum and cerebrospinal fluid calcium and magnesium levels in cases of idiopathic grand mal epilepsy and induced convulsions. J Assoc Phys India. 1981;29(9):695-9.

Woodbury J, Lons K, Carretta R, Hahn A, Sullivian J. Cerebrospinal fluid and serum levels of magnesium, calcium. Neurology. 1968;18:700.

Baek SJ, Byeon JH, Eun SH, Eun BL, Kim GH. Risk of low serum levels of ionized magnesium in children with febrile seizure. BMC Pediatr. 2018;18(1):297.

Kannachamkandy L, Kamath SP, Mithra P, Shenoy J, Bhat KG, Baliga BS. Association between serum micronutrient levels and febrile seizures among febrile children in Southern India: A case control study. Clin Epidemiol Global Health. 2020;8(4):1366-70.

Sherlin I, Balu Ramu. Magnesium Level in Febrile Convulsions. Int J Sci Res. 2014;3(10):850-1.

Goutham A, Dhingra P, Shankar P. Serum Magnesium Level in Febrile Convulsion. Int J Gen Pediatr Med. 2017;2(1):7-10.

Bharathi S, Chiranjeevi K. Study of serum magnesium levels and its correlation with febrile convulsions in children aged 6 months to 5 years of age. Int Arch Integrated Med. 2016;3:61-8.

Rude RK. Magnesium metabolism and deficiency. Endocrinol Metab Clin North Am. 1993;22(2):377-95.

Wallace S. Investigation at presentation. The Child with Febrile Seizures. London: Wright. 1988;70-80.

Kiviranta T, Airaksinen EM, Tuomisto L. The role of fever on cerebrospinal fluid glucose concentration of children with and without convulsions. Acta Paediatr. 1995;84(11):1276-9.

Valerio G, Franzese A, Carlin E, Pecile P, Perini R, Tenore A. High prevalence of stress hyperglycaemia in children with febrile seizures and traumatic injuries. Acta Paediatr. 2001;90(6):618-22.

Reimers JI. Interleukin-I beta induced trasient diabetes mellitus in rats. A model of the initial events in the pathogenesis of insulin-dependent diabetes mellitus. Dan Med Bull. 1998;45:157-80.

Dinarello CA. Biology of interleukin-1. FASEB J. 1988;2:108-15.

Lang CH, Cooney R, Vary TC. Central interleukin-1 partially mediates endotoxin-induced changes in glucose metabolism. Am J Physiol. 1996;271(2):309-16.

Prasad R, Singh AR, Das BK, Upadhyay RS, Singh TB, Mishra OP. Cerebrospinal fluid and serum zinc, copper, magnesium and calcium Levels in children with idiopathic seizure. J Clin Diagn Res. 2009;1841-6.

Sakha K, Barzar M. Evaluation of Serum Sodium and Ionized Calcium Levels in Febrile Convulsions. Pediatr Med Chir. 1985;7(2):249-52.

Sood AK, Handa R, Malhotra RC, Gupta BS. Serum, CSF, RBC, Urinary Levels of Magnesium and Calcium in Idiopathic generalized tonic clonic Seizures. Indian J Med Res. 1993;98:152-9.

Kiviranta T, Tuomisto L, Airaksinen EM. Osmolality and electrolytes in cerebrospinal fluid and serum of febrile children with and without seizures. Eur J Pediatr. 1996;155(2):120-5.

Van Stuijvenberg M, Van Gijssel EN, Steyerberg EW, Moons KG, Derksen-Lubsen G, Moll HA. Seizures associated with fever: clinical data as predictors for normal biochemical blood levels. Eur J Pediatr. 1998;157(7):592-8.

Kenney RD, Taylor JA. Absence of serum chemistry abnormalities in pediatric patients presenting with seizures. Pediatr Emerg Care. 1992;8(2):65-6.