comparison of serum zinc and copper levels in children and adolescents with intractable and controlled epilepsy

how to cite this article: kheradmand z, yarali b, zare a, pourpak z, shams s, ashrafi mr. comparison of serum zinc and copper levels in children and adolescents with intractable and controlled epilepsy. iran j child neurol. 2014; 8(3):49-54.   abstract objective trace elements such as zinc and copper have physiological effects on neuronal excitability that may play a role in the etiology of intractable epilepsy. this topic has been rarely discussed in iranian epileptic patients. this study with the analysis of serum zinc and copper levels of children and adolescents with intractable and controlled epilepsy may identifies the potential role of these two trace elements in the development of epilepsy and intractability to antiepileptic drug treatment.  materials & methods seventy patients between the ages of 6 months to 15 years that referred to children’s medical center with the diagnosis of epilepsy, either controlled or intractable to treatment enrolled in the study. after informed parental consent the levels of serum zinc and copper were measured with atomic absorption spectrophotometer and analyzed with spss version 11. results 35 patients were enrolled in each group of intractable (ie) and controlled epilepsy (ce). 71.45% of the ie and 25.72% of the ce group had zinc deficiency that was statistically significant. 48.58% of the ie and 45.72 of the ce group were copper deficient, which was not statistically significant. conclusion our findings showed significant low serum zinc levels of patients with intractable epilepsy in comparison with controlled epilepsy group.  we recommend that serum zinc level may play a role in the etiology of epilepsy and intractable epilepsy therefore its measurement and prescription may be regarded in the treatment of intractable epilepsy. references mikati ma. seizures in childhood. in: kliegman rm, stanton bf, schor nf, geme jws, behrman r (eds). nelson textbook of pediatrics. 19th ed. elsevier:saunders; 2011. pp.2013-2033. kwan p, brodie mj. early identification of refractory epilepsy. n engl j med 2000;342: 314-9. patrick kwan, alexis arzimanoglou, anne t. berg, et al.  definition of drug resistant epilepsy: consensus proposal by the ad hoc task force of the ilae commission on therapeutic strategies. epilepsia 2010;51(6):1069-1077. berg at, shinnar s, levy sr, testa f, smith-rapaport s, beckerman b. early development of intractable epilepsy in children: a prospective study. neurology 2001;56:1445-1452. haoa xt, wong ism, kwan p. interrater reliability of the international consensus definition of drug-resistant epilepsy: a pilot study. epilepsy & behavior 2011;22;388-390.  ashrafi mr, mohseni m, shams s, shabanian r, yekaninejad ms, et al. a probable causative factor for an old problem: selenium and glutathione peroxidase appear to play important roles in epilepsy pathogenesis. epilepsia 2007;48(9):1750-1755. liochev si, fridovich, i. copper- and zinc-containing superoxide dismutase can act as a superoxide reductase and a superoxide oxidase. j biol chem 2000; 275: 38482-38485. jacob ra. trace elements in textbook of clinical chemistry. wb saunders, 1986. pp. 965-985. salwen mj. vitamis and trace elements. in: pherson ra, pincus mr (eds). henry’s clinical diagnosis and management by laboratory methods tweny-first edition. saunders; 2007. pp. 379-389. rokgauerj m, klein j kruse-jarres j. d. reference values for the trace elements copper, manganese, selenium, and zinc in the serum/ plasma of children, adolescents, and adults. j trace element med biol. 1997;11: 92-98. volpe sl, schall ji, gallagher pr, stallings va, bergqvist agc. nutrient intake of children with intractable epilepsy compared with healthy children. journal of the american dietetic association 2007;107(6):1014-8. epub 2007/05/26. wojciak rw, mojs e, stanislawska-kubiak m, samborski w. the serum zinc, copper, iron, and chromium concentrations in epileptic children. epilepsy research 2013;104:40-44. hamed sa, abdellah mm, el-melegy n. blood levels of trace elements, electrolytes, and oxidative stress/ antioxidant systems in epileptic patients. j pharmacol sci 2004;96:465-473. dudek fe. zinc and epileptogenesis. epilepsy curr 2001; 1:66-70. mathie a, sutton gl, clarke ce, veale el. zinc and copper: pharmacological probes and endogenous  modulators of neuronal excitability. pharmacol ther. 2006;111(3):567-83. epub 2006/01/18. schrauzer gn. selenomethionine and selenium yeast: appropriate forms of selenium for use in infant formulas and nutritional supplements. journal of medicinal food 1998;1(3):201-6. seven m, basaran sy, cengiz m, unal s. deficiency of selenium and zinc as a causative factor for idiopathic intractable epilepsy. epilepsy research 2013;104 :35-39.