Association between serum micronutrient levels and febrile seizures among febrile children in Southern India: A case control study

Background: Febrile seizures are prevalent in children. Interactions between the neurotransmitters and micronutrients levels in the biological fluids have been implicated in its occurrence. Objective: To assess the serum copper (Cu), magnesium (Mg) and zinc (Zn) levels in febrile children and to evaluate their association with febrile seizures. Methods: The study included 35 children with febrile seizures as cases and 35 children with febrile illnesses without seizures as controls. Children between six months to five years were included in the study group. The serum Cu, Mg and Zn levels were analyzed by the semi-auto analyzer. Data analysis was done using SPSS Version 25.0. Result: The median age for the febrile seizure was 24 (IQR: 12–36) months with male preponderance of 65.7%. The median serum copper and magnesium levels were increased and decreased significantly (p < 0.001), among febrile seizure children in comparison to the control group. Median serum zinc levels in the febrile seizure group were less but were not statistically significant (p = 0.626). Higher serum levels of copper had higher odds of seizures (OR: 22.67; 95% CI: 2.73–495.98; p < 0.0001) and lower levels of magnesium had higher odds of seizures (OR: 29.41; 95% CI: 6.90–142.86; p < 0.0001). Serum copper levels had sensitivity and specificity of 80% and 71% respectively in predicting febrile seizure at a cutoff value of ≥19.55 μmol/L. Conclusion: Increased serum copper levels and decreased serum magnesium levels were significantly associated with febrile seizures. A threshold value of serum copper levels ≥19.55 μmol/L is associated with a febrile seizure.