Low serum zinc and magnesium–a possible risk factor for first episode Simple febrile seizures in children between 6 months to 5 years of age

Aishwarya Lakshmi L. G., Mohanraj Kannan, Rajakumar P. G., Selvaraj R.


Background: Febrile seizure is the most common type of seizure in children. The incidence of febrile seizure is 5-10% in India. There are multiple aetiologies like high grade fever; genetic predisposition, viral infections and trace elements deficiency like iron, zinc, magnesium and calcium are postulated to be risk factors for developing febrile seizures. Recent studies had shown there is a significant association between low serum zinc, low serum magnesium levels and febrile seizures in children.

Methods: This was a case control study with 40 children in each group. Children aged 6 months to 5 years with first episode of simple febrile seizures who attends the out-patient department/emergency room (OPD/ER) were included in case group consecutively and 40 children with acute febrile illness without febrile seizures were included in control group. Serum zinc and magnesium levels were estimated for all the children along with other investigations after proper consent from parents. Using statistical package for the social sciences (SPSS) software, independent sample t test was used to analysis the observations between the two groups. Normal lab reference value of serum zinc was 60-120 μg/dl and serum magnesium was 1.7-2.5 mg/dl.

Results: The incidence of febrile seizure was high (37.5%) in children between 1-2 years and male (55%) children had increased incidence when compared to female children in case group. The children with febrile seizure had significantly low levels of serum zinc with mean value of 35.08 μg/dl (±8.56) when compared to control group with mean value of 70.23 μg/dl (±13.41) and serum magnesium level in case group was 1.35 mg/dl (±0.29) versus 1.68 mg/dl (±0.42) in control group, which was also statistically significant.

Conclusions: The incidence of febrile seizure was high in children between 1-2 years of age with male preponderance. The serum levels of both zinc and magnesium is significantly low in children with febrile seizure pointing a need of further studies in role of supplemental zinc and magnesium in this age group to reduce the incidence of febrile seizures.



Febrile seizure, Serum zinc, Serum magnesium

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Pan E, Zhang XA, Huang Z, Krezel A, Zhao M, Tinberg CE, Lippard SJ, McNamara JO. Vesicular zinc promotes presynaptic and inhibits postsynaptic long-term potentiation of mossy fiber-CA3 synapse. Neuron. 2011;71(6):1116-26.

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.

Berg AT, Shinnar S, Darefsky AS. Predictors of recurrent febrile seizures. A prospective cohort study, Arch Pediatraddex Med. 1997;151:35-8.

Rehman N, Billoo AG. Association between febrile seizures and iron deficiency anaemia. Journal of college of physicians and surgeons Paksitan. 2005;15(6):338-40.

van Esch A, Steyerberg EW, van Duijn CM, Offringa M, Derksen-Lubsen G, van Steensel-Moll HA. Prediction of febrile seizures in siblings: a practical approach. Eur J Pediatr. 1998;157(4):340-4.

Izumi Y, Ishii K, Akiba K. Hypozincemia during fever may trigger febrile convulsion. Med Hypothesis. 1990;32(1):77-80.

Ganesh R, Janakiraman L. Serum zinc levels are low in children with simple febrile seizures compared with those in children with epileptic seizures and controls. Ann Tropical Paediatr. 2011;31(4):345-9.

Talebian A, Vakili Z, Talar SA, Kazemi SM. Assessment of the Relation between Serum Zinc & Magnesium Levels in Children with Febrile Convulsion. Iranian J Pathol. 2009;4(4):157-60.

Goutham AS, Dhingra P, Shankar P. Serum magnesium levels in febrile convulsion. Int J Gen Paediatr Med. 2017;(2):7-10.