Serum levels of zinc and copper in epileptic children during long- term therapy with anticonvulsants

Epilepsy is a common neurological disorder with heterogeneous nature affecting 50 million people world wide, with more than 85% living in the developing world, and it begins in childhood in more than half of the cases. An estimated 4.7 million people with epilepsy live in the Eastern Mediterranean Region.1 The prevalence of epilepsy in Egypt is not accurately determined, although some studies reported that the lifetime prevalence rate of epilepsy is 12.67/1000.2 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. The absence of a specific cause of the seizures is called primary or idiopathic epilepsy.3 Some of the main causes of epilepsy include: low oxygen during birth; head injuries that occur during birth or from accidents during youth or adulthood; brain tumors; genetic conditions that result in brain injury, such as tuberous sclerosis; infections such as, meningitis or encephalitis; stroke; or any other type of damage to the brain and abnormal levels of substances such as, sodium or blood sugar.4 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.5 The routine treatment of the epilepsy is using anticonvulsant agents. The use of such drugs mainly controls the disease, or can reduce the times of the seizure. After initial recognition, approximately 70% of patients have controlled seizures with antiepileptic drugs (AEDs). Approximately 25% of patients with epilepsy do not have any observed improvement in the reduction of the amount of seizures, even when 2 or 3 AEDs are used. Some studies have shown the importance of a specific diet, hormones, and micronutrients in the management of patients with epilepsy.6 The aim of the present study was to evaluate serum levels of Cu and Zn in patients with epilepsy in long-term treatment with anticonvulsants and comparing this with healthy individuals.