From the Guidelines
Patients with seizure disorders may have low magnesium levels, particularly if their seizures are secondary to hypomagnesemia or other conditions such as hypocalcemia, fever, or medications. While the relationship between seizure disorders and magnesium levels is complex, some patients with seizure disorders may experience seizures triggered by low magnesium levels 1. According to the updated clinical practice recommendations for managing adults with 22q11.2 deletion syndrome, seizures deemed acute symptomatic or provoked may be secondary to hypomagnesemia, among other conditions 1.
Key points to consider in the management of patients with seizure disorders and potential low magnesium levels include:
- Seizures can be triggered by various factors, including hypomagnesemia, hypocalcemia, fever, and medications 1
- Patients with 22q11.2 deletion syndrome have a 4-fold increased risk of epilepsy and may experience seizures secondary to primary cerebral dysfunction or other associated conditions 1
- Treatment of seizures is tailored to seizure type and contributing conditions, and collaboration with a specialist may be recommended 1
- Checking magnesium levels may be worthwhile in patients with seizure disorders who experience frequent seizures despite medication, especially if they have other risk factors for magnesium deficiency 1
In terms of management, if low magnesium is detected, supplementation may be considered, typically starting with oral magnesium oxide 400-800 mg daily or magnesium citrate 300-600 mg daily, divided into 2-3 doses. Magnesium plays an important role in neuronal function by regulating calcium channels and NMDA receptors, which can influence seizure thresholds 1. However, routine magnesium supplementation is not recommended for seizure control unless a deficiency is confirmed.
From the Research
Magnesium Levels in Patients with Seizure Disorder
- Patients with seizure disorder may have lower magnesium levels than those without the condition, as suggested by some studies 2, 3.
- Magnesium deficiency has been shown to decrease seizure thresholds in animal models of epilepsy and is a common method of generating spontaneous epileptiform discharges from rat hippocampal slices 2.
- Low magnesium concentration has been associated with a wide range of medical conditions, including epilepsy, and may be a contributing factor to the onset and maintenance of the condition 2, 4.
Studies on Magnesium and Seizure Disorder
- A study published in 2012 found that people with epilepsy have lower magnesium levels than those without epilepsy, and hypothesized that magnesium supplementation can reduce seizures in people with epilepsy 2.
- Another study published in 2016 found that magnesium supplementation has been shown to raise seizure threshold in animal and human studies, but more research is needed to understand the potential role of magnesium deficiency as a causal factor in epilepsy 4.
- A study published in 2018 found that hypomagnesemia was more common in patients with febrile seizure than in controls, and that low serum ionized magnesium levels were an independent risk factor for febrile seizure 3.
Clinical Implications
- Recognizing and correcting magnesium deficiency may be important in the management of patients with seizure disorder, particularly those with acute intractable seizures 5.
- Magnesium supplementation may be a potential adjunctive treatment for patients with epilepsy, although more research is needed to confirm its efficacy 2, 4.