Iron Metabolism in Adult Patients with Epilepsy

Abstract Background Epilepsy is a disease characterized by recurrent, episodic, and transient central nervous system (CNS) dysfunction resulting from an excessive synchronous discharge of brain neurons and both the morbidity and mortality are high. Objective To compare between epileptic and non- epileptic patients regarding iron levels. Patients and Methods This case control study (pilot study) was conducted at neurology outpatient clinic, Faculty of Medicine, Ain Shams University Hospitals from August 2022 until July 2023. Results Our study outcome, serum iron level (mcg/dL) 158.45 ± 60.67 vs. 07.90 ± 29.92, serum ferritin (ng/mL) 187.76 ± 71.70 vs. 113.86 ± 42.75 and transferrin (iron) saturation % 45.87 ± 15.69 vs. 31.18 ± 5.57 were statistically significant higher among epileptic cases compared with control group. On the other hand, total iron binding capacity (mcg/dL) was higher 353.75 ± 98.07 vs. 343.85 ± 55.40 among epileptic cases compared with control group but with no significant value. Of note, there is no statistically significant difference between male and female, patient's age and duration of epilepsy according to iron profile in epileptic group. Also, there is no statistically significant difference between focal and GTC according to iron profile in epileptic group. Conclusion Iron overload is related to epilepsy. Increasing evidence demonstrates that epilepsy is closely related to ferroptosis and iron metabolism. Currently, there are many ways to regulate ferroptosis, but the regulatory mechanism of ferroptosis in epilepsy has not yet been understood. Targeting iron metabolism and ferroptosis may be a novel method to slow the progression of epilepsy. This type of treatment is yet to be discovered and explored. Nonetheless, ferroptosis is a newly identified and critical mechanism of cell death, especially in CNS disease. Anti-ferroptosis mechanisms and ferroptosis inhibitors play an essential role in preventing epilepsy.