Background: Cerebral palsy (CP), a neuromotor disorder caused by prenatal to neonatal brain injury, often leads to malnutrition. Children with CP commonly experience deficiencies in key trace elements like selenium and zinc, essential for immune function and neurodevelopment. This study aims to assess selenium status by selenium binding protein (BP)and zinc levels, in malnourished pediatric CP patients and correlate their levels with nutritional status and infection.

Methods: This case-control study included 70 participants (35 malnourished CP children and 35 healthy controls, all under 18 years) from the pediatric department at Zagazig University Hospital. Zinc levels were assessed using a colorimetric method, and selenium-binding protein levels were measured using ELISA.

Results: Anthropometric measurements were all significantly smaller in the cases group than in the control group (P<0.0001 for all). The patient group hemoglobin levels were significantly lowered. P=0.0033) while white blood cell (WBC) counts were significantly higher (P<0.0001), as were C-reactive protein (CRP) levels (P<0.0001). Gram-negative bacilli were more commonly detected in the patients group (22.86% vs. 0%, P=0.005). Additionally, albumin, zinc, and selenium binding protein (BP) levels were significantly lower in the patients group. Cutoff values for zinc (<67.44µg/dL) and selenium BP (<191.08ng/dL) showed acceptable sensitivity and accuracy as predictors of CP in pediatric malnourished patients. Serum zinc and selenium BP levels exhibited significant positive correlations with growth parameters and negative correlations with CRP.

Conclusion: Malnourished pediatric CP patients show significant deficiencies in zinc and selenium BP, which contribute to growth impairments and increased infection risk.