Unraveling the nutritional challenges in epilepsy: Risks, deficiencies, and management strategies: A systematic review

Table 5 summarizes the relationships between mineral deficiencies and epilepsy, including associated conditions, causes of deficiencies, and management strategies

Mineral deficiency	Mechanisms in epileptogenesis	Associated conditions	Causes of deficiencies	Management strategies
Magnesium	Modulates neuronal excitability by blocking calcium channels. Reduces NMDA receptor activation, lowering neuronal excitability. Prevents excessive calcium influx, mitigating excitotoxicity	Hypomagnesemia is linked to seizures and epilepsy	Inadequate dietary intake, malabsorption, renal disorders, and medications	Magnesium supplementation, dietary changes, addressing underlying health issues
Zinc	Modulates neurotransmission and influences NMDA receptors. Acts as an antioxidant and protects against oxidative stress	Serum zinc concentrations vary in epilepsy; both high and low levels are reported	Dietary insufficiency, malabsorption, genetic factors	Zinc supplementation, balanced diet, investigation into underlying causes
Calcium	Regulates neuronal excitability and neurotransmitter release. Excessive influx to excitotoxicity; deficiency may predispose to seizures	Hypocalcemia or hypercalcemia may impact neurological function	Hormonal imbalances, dietary deficiency, renal disorders, vitamin D deficiency	Dietary changes, calcium supplements, and medical treatment for underlying conditions
Sodium	Essential for generating and propagating action potentials. Dysfunctions in sodium channels can alter neuronal excitability	Dysnatremias can affect neuronal function, but the link to epileptogenesis varies	Dehydration, excessive sweating, kidney disorders, medication side effects	Fluid/electrolyte balance, addressing underlying health issues, medication adjustments
Potassium	Maintains resting membrane potential and influences action potential generation. Changes can affect the neuronal firing threshold	Imbalances can cause neuromuscular issues, but a direct link to epilepsy varies	Dietary insufficiency, renal problems, medications	A balanced diet, potassium supplements, and managing underlying health conditions
Iron	Essential for neurotransmitter synthesis and oxygen transport. Imbalance can lead to oxidative stress and neuroinflammation	Iron deficiency or excess might influence seizure susceptibility but complex relationship	Poor diet, malabsorption, menstrual bleeding, genetic disorders	Iron supplements, dietary modifications, treating underlying conditions
Selenium	Acts as an antioxidant and influences immune function and neurotransmitter systems. Role in GABAergic transmission	Oxidative stress and immune dysregulation linked to epilepsy	Dietary deficiency, soil depletion, absorption issues	Selenium supplementation, balanced diet, addressing absorption issues

NMDA: N-methyl-D-aspartate.