ich freue mich, daß sich Prof. Hufnagel so eindeutig zu Magnesiummangel äußert. Ich bin nur erstaunt, daß man die Mg-Spiegel nicht routinemäßig nimmt, wenn der Zusammenhang so klar ist.
Was die Häufigkeit von Magnesiummangel angeht, stelle ich hier einmal ein paar Artikel ins Forum, die ich schon vor einiger Zeit gefunden habe. Sie sind leider in englischer Sprache. Deshalb übersetze ich Euch die entscheidenen Sätze, die ich in den Artikeln fett schreiben werde:
1. Niedrige Magnesiumspiegel korrelierten mit erhöhter Frequenz, schlechter Kontrolle und längerer Dauer der Anfälle. Patienten mit einem Status epilepticus und Patienten mit EEG-Auffälligkeiten hatten niedrige Magnesiumspiegel.
2. Niedrige Plasma-Magnesiumspiegel stehen im Zusammenhang mit Epilepsie, weitere Studien könnten den Einfluß der antiepileptischen Medikation auf die Magnesiumspiegel bestimmen.
3. Die Konzentrationen von Mg bei krampfenden Kindern waren signifikant niedriger als bei nicht krampfenden Kindern. FAZIT: Diese Ergebnisse zeigen, daß die Entstehung von Krämpfen in Zusammenhang steht mit altersabhängigen Veränderung von iCA (Calcium) und verringertem Mg im sich entwickelnden Gehirn.
4. Je geringer der Abfall der Mg-Spiegel, um so seltener waren die Krämpfe und umgekehrt. Es wird geschlossen, daß Serum-Magnesium weiterhin ein empfindlicher Anzeiger zur Frühdiagnose idiopathischer Epilepsie ist.
5. Der Prozentsatz von Patienten mit erniedrigten RBC Mg stieg mit der Dauer der antiepileptischen Behandlung an;
6. Mit beiden Methoden wurde eine signifikant erniedrigte Mg-Konzentration im Plasma von Epileptikern gefunden. Eine positive Korrelation zwischen Hypomagnesie und der Schwere der Epilepsie wurde gefunden: je schwerer die Epilepsie, desto niedriger war das Plasma-Mg.
1: Indian J Med Res. 1993 Jun;98:152-4. Links
Serum, CSF, RBC & urinary levels of magnesium & calcium in idiopathic generalised tonic clonic seizures.
• Sood AK,
• Handa R,
• Malhotra RC,
• Gupta BS.
Department of Medicine, Medical College & Hospital, Rohtak.
Serum, cerebrospinal fluid (CSF) and urinary levels of magnesium and calcium and RBC magnesium levels were studied in 100 patients of idiopathic generalised tonic clonic seizures and 95 healthy controls matched for age and sex. There was a significant reduction in serum, CSF and RBC magnesium levels and a rise in serum and CSF calcium levels in epileptic patients. The 24 h urinary excretion of calcium and magnesium in the epileptics did not differ from controls. Post ictal (within 24 h of seizure) serum and CSF magnesium levels were significantly lower and calcium levels significantly higher as compared to inter ictal levels (4 wk after seizure). There was no correlation between serum magnesium, serum calcium and CSF calcium levels and the frequency, control or duration of fits. Low CSF magnesium levels correlated with increased frequency, poor control and longer duration of fits. Patients with status epilepticus and those in the EEG abnormalities had low CSF magnesium levels.
PMID: 8225453 [PubMed - indexed for MEDLINE]
Niger Postgrad Med J. 2003 Dec;10(4):234-7. Links
Plasma magnesium in adult Nigerian patients with epilepsy.
• Oladipo OO,
• Ajala MO,
• Okubadejo N,
• Danesi MA,
• Afonja OA.
Department of Clinical Pathology, College of Medicine, Idi-Araba, Lagos, Nigeria.
The objective of this study was to determine the relationship between plasma magnesium levels and epilepsy. The study was carried out at the Lagos University Teaching Hospital. Plasma magnesium was estimated using the calmigite dye colorimetric method in 45 adults with epilepsy and 35 healthy controls. Plasma concentrations of calcium, phosphorus and albumin were also estimated. The mean plasma magnesium in the patients was 0.98 mm0l/L (0.05) while that in the controls was 1.15 mmol/L (0.28). The mean plasma magnesium in the epileptics was significantly lower than that obtained in the controls (p < 0.001). Age of onset of seizures, seizure frequency and duration of treatment did not influence the plasma magnesium levels. Low plasma magnesium is associated with epilepsy, further studies may determine the influence of anti-epileptic drug therapy on plasma magnesium levels.
Keywords: magnesium, seizures, Nigeria.
PMID: 15045017 [PubMed - indexed for MEDLINE]
1: Pediatr Int. 2004 Aug;46(4):394-7. Links
Studies on cerebrospinal fluid ionized calcium and magnesium concentrations in convulsive children.
• Miyamoto Y,
• Yamamoto H,
• Murakami H,
• Kamiyama N,
• Fukuda M.
Department of Pediatrics, St. Marianna University School of Medicine, Kawasaki, Japan. firstname.lastname@example.org
BACKGROUND: The concentrations of ionized calcium (iCa) and ionized magnesium (iMg) were measured in the cerebrospinal fluid (CSF) of convulsive and non-convulsive children, to investigate the relationship between seizure manifestation and CSF iCa and iMg concentrations. Standard concentrations of CSF iCa and iMg were also established. METHODS: CSF samples from 23 patients, ages 0-15 years, with various forms of seizures and 26 age-matched non-convulsive children were collected by lumbar puncture. CSF was obtained anaerobically and the concentrations of CSF iCa and iMg were measured with an electolyte analyzer (Stat Profile Ultra M1, NOVA, USA) immediately after the lumbar puncture. RESULTS: The concentrations of CSF iCa were significantly higher in non-convulsive children younger than 11 months old compared with children older than 12 months. The concentrations of CSF iMg in non-convulsive children did not differ significantly with aging. The concentrations of CSF iCa in convulsive children did not differ significantly from the concentrations of non-convulsive children. The concentrations of CSF iMg in convulsive children were significantly lower than in non-convulsive children. CONCLUSION: These results suggest that seizure manifestation is related to age-dependent changes in iCa and decreased iMg in the developing brain.
PMID: 15310301 [PubMed - indexed for MEDLINE]
1: J Assoc Physicians India. 1994 Jun;42(6):456-7. Links
Serum magnesium levels in idiopathic epilepsy.
• Gupta SK,
• Manhas AS,
• Gupta VK,
• Bhatt R.
Department of Medicine, Government Medical College, Jammu.
Fifty cases of idiopathic epilepsy and 25 age and sex matched normal healthy controls were studied. There was a significant fall in serum magnesium levels in idiopathic epilepsy on day one and 4 of the seizures (P < 0.01) as compared to controls, and was not decreased significantly on day 7 of the seizures (P < 0.05). The fall was maximum in status epilepticus and severe epilepsy than in mild and moderate epilepsy. Serum magnesium took less time to come back to normal in mild and moderate epilepsy than in other types. This shows that serum magnesium does have a prognostic significance. Lesser the fall in the magnesium levels, less frequent were the convulsions and vice versa. It is concluded that serum magnesium continues to be a sensitive early diagnostic index of idiopathic epilepsy.
PMID: 7852227 [PubMed - indexed for MEDLINE]
1: Magnesium. 1987;6(6):284-95. Links
Metabolism of magnesium and zinc in patients treated with antiepileptic drugs and with magnesium lactate.
• Steidl L,
• Tolde I,
• Svomova V.
Neurological Clinic, Palacky University, Olomouc, Czechoslovakia.
Fourty-nine patients were examined with epileptic seizures and values of serum and erythrocyte magnesium (sMg, RBC Mg) and serum zinc (sZn) were determined. Chronic deficiency in RBC Mg and sZn were confirmed. The percentage of patients with decreased RBC Mg increased with the time of antiepileptic treatment;
significant lowering occurs after 5 years of treatment for RBC Mg and within 5 years for sZn. Various antiepileptics and their combinations have different effects on the degree of the lowering. The therapy of magnesium lactate produces significantly higher RBC Mg and sZn. The clinical, electroencephalographical and biochemical findings are improved.
PMID: 3129621 [PubMed - indexed for MEDLINE]
1: J Neurol Sci. 1985 Jan;67(1):29-34. Links
Plasma and cerebrospinal fluid concentrations of magnesium in epileptic children.
• Benga I,
• Baltescu V,
• Tilinca R,
• Pavel O,
• Ghiran V,
• Muschevici D,
• Benga G.
In order to discriminate between conflicting reports in the literature, plasma and cerebrospinal fluid magnesium levels from epileptic children were compared with those of control children. To exclude the possibility of methodological artifacts, two methods for Mg determination were used: atomic absorption spectrophotometry and a colorimetric procedure. By both methods a significantly decreased concentration of Mg in plasma was found in epileptics. A positive correlation of the hypomagnesemia with the severity of epilepsy was found: the more severe the epilepsy, the lower was the plasma Mg.
A significant increase of Mg concentration in CSF of epileptics was found. The most likely origin of Mg in CSF in epilepsy is the CNS tissue from which Mg is released. It is suggested that these alterations of Mg concentrations in plasma and CSF originate from a functional impairment of the cell membranes which might occur in epilepsy.
PMID: 3981211 [PubMed - indexed for MEDLINE]