Suboptimal intake of magnesium has become prevalent owing to the modern diet of processed food. Magnesium benefits by modulating seizure activity via antagonizing excitatory calcium influx through the N-methyl-D-aspartate receptor. Although hyponatremia has been reported to be common in febrile seizures, the most common form of seizure; however, little is known about the status of serum ionized magnesium.

The objective of a study published in BMC Pediatrics was to investigate the status of serum ionized magnesium (iMg2+) in children with febrile seizures, compared to controls.

Here, all patients—1-6 years olds—who had presented with febrile seizure to the pediatric emergency department at the Korea University Guro Hospital from July 2016 to February 2017, were recruited. The control group comprised patients admitted to the hospital with febrile respiratory tract infections, but with no history of febrile seizure. Clinical data, blood tests and electroencephalogram (EEG) results were reviewed using the patients’ medical records.

Overall, 133 patients with febrile seizure and 141 control patients were analyzed. The results revealed that hypomagnesemia (< 0.50 mmol/L) was more common in patients with febrile seizure than in controls (42.9% versus 6.9%) and it was an independent risk factor for febrile seizure. A receiver operating curve analysis disclosed that serum iMg2+ levels < 0.51 mmol/L predicted the presence of febrile seizures with a sensitivity of 45.1% and a specificity of 92.6%. When patients with febrile seizure were divided in terms of a serum iMg2+ concentration of 0.51 mmol/L, there was no difference in clinical features.

From the findings, it was concluded that hypomagnesemia was more common and serum iMg2+ level was lower in patients with febrile seizures than in controls. Further evidence is needed to establish the causal relationship between low magnesium and febrile convulsions.

Source: BMC Pediatrics. 2018 Sep 7;18(1):297. doi: 10.1186/s12887-018-1271-z.