DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20212218

The relationship between magnesium and seizure control in epileptic patients

Yonathan A. Suparman, Herlyani Khosama, Corry N. Mahama

Abstract


Background: Magnesium has a central nervous system depressant effect by inhibiting the N-methyl-D-aspartate (NMDA) receptor, an antagonist of calcium channels, and increasing the surface tension of the cell membrane. Patients with epilepsy who had seizures more than 4 times/week had lower serum magnesium levels than those with the episode of less than or equal to 1 time/week. A low dose of magnesium added to phenytoin or carbamazepine can reduce seizure frequency. We want to evaluate the relationship between serum magnesium levels and their dietary intake level with seizure control in Manado.

Methods: Patients with epilepsy aged 18-65 years, from July 2019 to October 2019, were tested for dietary and serum magnesium level in the last 30 days using NutriSurvey software. Regression models were used to quantify the relationship between dietary and serum magnesium level with seizure freedom and its frequency in the last 30 days.

Results: One hundred and ten epileptic patients were included in this study. The median serum magnesium level is 2 mg/dl. There was no significant relationship between serum magnesium levels and seizure freedom (p=0.423) or its frequency in the last 30 days (p=0.966). Dietary magnesium intake (OR 1.01; 95% CI 1.00-1.02, p=0.034) was associated with seizure freedom but not with its frequency (p=0.423).

Conclusions: Dietary magnesium intake was associated with seizure freedom, but serum magnesium levels were not associated with seizure freedom or frequency.


Keywords


Serum magnesium level, Dietary magnesium intake, Seizure freedom, Seizure frequency

Full Text:

PDF

References


Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, et al. ILAE Official Report: A practical clinical definition of epilepsy. Epilepsia. 2014;55(4):475-82.

Kwan P, Brodie MJ. Early Identification of Refractory Epilepsy. N Engl J Med. 2000;342(5):314-9.

Wassenaar M, Leijten FSS, Egberts TCG, Moons KGM, Uijl SG. Prognostic factors for medically intractable epilepsy: A systematic review. Epilepsy Res. 2013;106(3):301-10.

Abdelmalik PA, Politzer N, Carlen PL. Magnesium as an Effective Adjunct Therapy for Drug Resistant Seizures. Can J Neurol Sci. 2012;39(03):323-7.

Yary T, Kauhanen J. Dietary intake of magnesium and the risk of epilepsy in middle-aged and older Finnish men: A 22-year follow-up study in a general population. Nutrition. 2019;58:36-9.

Dhande P, Ranade R, Ghongane B. Effect of magnesium oxide on the activity of standard anti-epileptic drugs against experimental seizures in rats. Indian J Pharmacol. 2009;41(6):268.

Al-Janabi JM, Mossa M. Determination of calcium & magnesium in the serum of epileptic patients. Med J Tikrit. 2005;2(112):41-3.

Akter S, Eguchi M, Nanri A, Kochi T, Kashino I, Kuwahara K, et al. Association of dietary and serum magnesium with glucose metabolism markers: The Furukawa Nutrition and Health Study. Clin Nutr ESPEN. 2018;24:71-7.

Han H, Fang X, Wei X, Liu Y, Jin Z, Chen Q, et al. Dose-response relationship between dietary magnesium intake, serum magnesium concentration and risk of hypertension: a systematic review and meta-analysis of prospective cohort studies. Nutr J. 2017;16(1):26.

Jahnen-Dechent W, Ketteler M. Magnesium basics. Clin Kidney J. 2012;5(1):13-4.

Al Alawi AM, Majoni SW, Falhammar H. Magnesium and Human Health: Perspectives and Research Directions. Int J Endocrinol. 2018;2018:1-17.

Romani AMP. Cellular magnesium homeostasis. Arch Biochem Biophys. 2011;512(1):1-23.

Houillier P. Mechanisms and Regulation of Renal Magnesium Transport. Annu Rev Physiol. 2014;76(1):411-30.

Osborn KE, Shytle RD, Frontera AT, Soble JR, Schoenberg MR. Addressing potential role of magnesium dyshomeostasis to improve treatment efficacy for epilepsy: A reexamination of the literature. J Clin Pharmacol. 2016;56(3):260-5.

Isaev D, Ivanchick G, Khmyz V, Isaeva E, Savrasova A, Krishtal O, et al. Surface charge impact in low-magnesium model of seizure in rat hippocampus. J Neurophysiol. 2012;107(1):417-23.

Yuan F, Jia R, Gao Q, Yang F, Yang X, Jiang Y, et al. Early Predictors of Drug-Resistant Epilepsy Development after Convulsive Status Epilepticus. Eur Neurol. 2018;79(5-6):325-32.

Neligan A, Shorvon SD. Frequency and Prognosis of Convulsive Status Epilepticus of Different Causes: A Systematic Review. Arch Neurol. Arch Neurol. 2010;67(8):931-40.

Pujar SS, Martinos MM, Cortina-Borja M, Chong WKK, De Haan M, Gillberg C, et al. Long-term prognosis after childhood convulsive status epilepticus: a prospective cohort study. Lancet Child Adolesc Health. 2018;2(2):103-11.

Christiansen C, Rodbro P, Sjo O. “Anticonvulsant Action” of Vitamin D in Epileptic Patients? A Controlled Pilot Study. BMJ. 1974;2(5913):258-9.

Rimahardika R, Subagio HW, Wijayanti HS. Asupan vitamin d dan paparan sinar matahari pada orang yang bekerja di dalam ruangan dan di luar ruangan. J Nutr Coll. 2017;6(4):333.

Holló A, Clemens Z, Kamondi A, Lakatos P, Szűcs A. Correction of vitamin D deficiency improves seizure control in epilepsy: A pilot study. Epilepsy Behav. 2012;24(1):131-3.

Setiati S, Oemardi M, Sutrisna B. The role of ultraviolet-B from sun exposure on vitamin D3 and parathyroid hormone level in elderly women in Indonesia. Asian J Gerontol Geriatr. 2007;2:126-32.

Uwitonze AM, Razzaque MS. Role of Magnesium in Vitamin D Activation and Function. J Am Osteopath Assoc. 2018;118(3):181.