Comparison of the serum concentrations of micronutrients zinc and iron in epileptic children before and after administration of valproic acid

Abstract

Introduction: The mortality rate of epileptic patients has increased despite advances in the treatment of epilepsy. Several studies have indicated that changes of micronutrient homeostasis led to seizures. The anticonvulsant valproic acid affects the intracellular concentration of micronutrients. Objective: To compare the serum concentrations of micronutrients zinc and iron in paediatric patients with epilepsy before and after administration of valproic acid. Method: A prospective cohort design study was conducted in children with epilepsy from July to December 2019 in the outpatient department of paediatric neurology, Dr. Soetomo Regional Public Hospital, Surabaya, Indonesia. Serum concentrations of micronutrients zinc and iron were measured using the colorimetric method. Statistical analysis used paired t-test with p<0.05 being considered significant. Results: The study sample comprised 20 children with epilepsy. There were 13 (65%) males. Eight (40%) children were in the 1-5 year age group. Seizure type was generalised in 18 (90%) patients. The mean serum iron concentrations before and after valproic acid treatment were 23.9±16.8 µmol/L and 25.8±16.4 µmol/L respectively (p=0.700). The mean serum zinc concentrations before and after valproic acid treatment were 13±16.8 µmol/L and 26.8±15.4 µmol/L respectively (p=0.004). Conclusions: There was a statistically significant increase in the mean serum zinc concentration after valproic acid treatment in children with epilepsy. There was however no statistically significant increase in the mean serum iron concentration after valproic acid treatment in children with epilepsy.