Complex Febrile Seizures Research Articles

Complex Febrile Seizures: Usual and the Unusual.

Febrile seizures account for 2 to 14% of all childhood seizures, and one-third of febrile seizures are complex febrile seizures. Despite this, there is a lack of clinical equipoise in the diagnosis and management of complex febrile seizures and this results in significant practice variability amongst physicians. Although febrile seizures are generally noted to be benign phenomenon, complex febrile seizures carry the risk of subsequent epilepsy. Furthermore, long-term neurodevelopmental sequelae have been observed in some cohorts. The presence of both simple and complex febrile seizures have also been documented in sudden unexpected death in childhood cohorts, and there may be similarities in the underlying pathophysiology to sudden unexpected death in epilepsy. Finally, in some cases the presence of complex febrile seizures may herald the onset of a devastating developmental and epileptic encephalopathy (i.e., Dravet syndrome) or Febrile-Infection Related Epilepsy Syndrome (FIRES). In this narrative review the authors explore the current state of management of complex febrile seizures, their neurological sequelae and morbidity as well as rare epilepsy syndromes and conditions associated with them.

Evaluation of Febrile Seizures Focusing on the Diurnal Variation.

Background and objectives Several studies have reported the diurnal variation of febrile seizures (FS) in children. However, it remains unclear whether there is a difference in diurnal variation depending on the types of FS. The present study aims to investigate whether simple FS or complex FS influences diurnal fluctuations. Methods In this single-facility retrospective study, Japanese pediatricians collected clinical data from 247 children with FS. We evaluated the diurnal occurrence of FS using medical files. The Kolmogorov-Smirnov test was used to assess differences in distribution by classifying days into four six-hour time periods: night (0:00-6:00), morning (6:00-12:00), afternoon (12:00-18:00), and evening (18:00-24:00). Results In the simple FS group, the highest rate was observed in the evening (35.16%), followed by the afternoon (29.69%), with the lowest rate in the morning (14.06%). In the complex FS group, the highest rates were observed in both the afternoon (30.95%) and evening (30.95%), with the lowest rate at night (16.67%). The distributions of simple FS and complex FS were significantly different. Conclusion FS exhibited different diurnal variations depending on the type of FS. Clinicians' recognition of these findings will aid in treatment.

Assessment Of Risk Factors For Recurrent Febrile Seizures Among Children Aged Below 5 Years

Background: Febrile seizures are seizures that occur between the ages of 6 and 60 months with a temperature of 100.4°F or higher, that are not result of CNS infection or any metabolic imbalance and that occur in the absence of a history of prior afebrile seizures. They occur in around 2% of 5% of children and recurrence is seen in about one-third of children. Very few studies till now reported the risk factors of recurrence of febrile seizure from India. Therefore, the present study was conducted to know the risk factors associated with recurrence of febrile seizures among South Indian children. Objectives: 1. To know the incidence of recurrence of febrile seizures among children. 2. To study the risk factors of recurrent febrile seizures among children aged below 5 years. Materials and Methods: 50 children with febrile seizures were included. The study was done in the Department of Pediatrics at ASRAM, Eluru, Andhra Pradesh, India. Male and females children aged 6 months to 5 years with clinical features suggesting febrile seizures were included. Results: Among 50 children included, 22 had recurrent febrile seizures and 28 had no recurrent febrile seizures. Overall 29 children were males. Family history of febrile seizures, young age, family history of epilepsy, temperature below 102°F, less duration of fever, complex febrile seizures are found to be risk factors for recurrence. Gender and duration of febrile seizures were not associated with the recurrence. Conclusion: The current study revealed that younger age at onset of 1 st episode of seizure, lower temperature during the episode, brief duration between onset of fever and seizure episode and family history of febrile seizures were associated with recurrence of febrile seizures.

Pre-hospital and hospital treatment of febrile seizures

Given that febrile seizures are a common reason for both hospital and pre-hospital visits to physicians, and in the absence of a clear consensus on guidelines for treatment, especially for complex febrile seizures (CFS), we aim to examine their characteristics and treatment in order to improve the approach to the issue. This is an observational, retrospective, single-centre study including paediatric patients seen after a seizure associated with a febrile illness in the emergency department of a second-level hospital between September 2021 and December 2023. Epidemiological, clinical and treatment variables were collected. A total of 266 febrile seizures were included in the study: 188 (70.7%) were simple, and 78 (29.3%) were complex. Most benzodiazepines were administered during pre-hospital treatment (82%), and the transmucosal route was used in 70.3% of cases, despite the patient being in a healthcare environment. Complementary tests were performed in 70.6% of cases, blood tests in 65.6%, and nasopharyngeal swabs for viruses in 79.3%. A total of 73.6% of the tests requested were for patients with a focus of the fever. Extensive use of complementary tests persists, despite the identification of a focus of the fever in most patients. Our results show that systematic complementary tests and the admission of patients who have presented a CFS would not be justified, and each individual case should be considered.

Dyke-Davidoff-Masson syndrome – A dainty spectrum with a diligent diagnosis

ABSTRACT Dyke-Davidoff-Masson syndrome is a rare condition of unknown frequency resulting from brain injury, especially in early life, due to a multitude of causes. We present the case of a 2-year-old, developmentally normal female who presented with one episode of unprovoked generalized tonic-clonic seizures. This child had a history of complex febrile seizures at 1.5 years of age and was started on levetiracetam (20 mg/kg/day). During the current evaluation, a magnetic resonance imaging (MRI) brain showed left hemi cerebral atrophy. The literature review revealed that these findings are consistent with Dyke-Davidoff-Masson syndrome. The child was discharged with oral levetiracetam (30 mg/kg/day) and counseling from parents regarding the need for long-term treatment and follow-up. Due to its rarity, Dyke-Davidoff-Masson syndrome may easily be missed by the treating physician. Knowledge of its radio-imaging features enables timely and accurate diagnosis, allowing appropriate management.

Elevated cerebrospinal fluid neuronal injury biomarkers within 24 hours of onset in infection-triggered acute encephalopathy compared to complex febrile seizures

ObjectiveThis study aimed to measure and compare cerebrospinal fluid neuronal injury biomarkers in the acute phase of complex febrile seizure (CFS) and infection-triggered acute encephalopathy (AE). Furthermore, we determined the pathogenesis of AE with biphasic seizures and late reduced diffusion (AESD). MethodsPediatric patients with febrile status epilepticus who visited Hyogo Prefectural Kobe Children's Hospital from November 1, 2016, to December 31, 2022, and whose cerebrospinal fluid samples were collected within 24 h of neurological symptom onset were included. Patients were classified as having CFS or infection-triggered AE according to their definitions. Patients with AE were further categorized into AESD or unclassified AE. Cerebrospinal fluid biomarkers (neuron-specific enolase, growth differentiation factor 15 [GDF-15], S100 calcium-binding protein B [S100B], glial fibrillary acidic protein, and tau protein were measured and compared among the groups. ResultsTotal of 63 patients (45 with CFS and 18 with AE) were included. Among the AE patients, nine were classified as having AESD and nine as having unclassified AE. S100B levels were significantly higher in patients with AESD than in patients with CFS (485 pg/ml vs. 175.3 pg/ml) and were even higher in patients with AESD and neurological sequelae (702.4 pg/ml). GDF-15 levels were significantly elevated in patients with AE compared to patients with CFS (85.8 pg/ml vs. 23.6 pg/ml). ConclusionsThe elevation of S100B suggests that activated astrocytes may be closely associated with the early pathology of AESD. Elevated GDF-15 levels in infection-triggered AE suggest the activation of defense mechanisms caused by stronger neurological injury.

Serum Sodium Status in Children with Simple and Complex Febrile Seizure: A Comparative Hospital Based Study

Serum Sodium Status in Children with Simple and Complex Febrile Seizure: A Comparative Hospital Based Study

Prescription patterns of home rescue benzodiazepines for febrile seizures

ObjectiveTo describe the prescription patterns of home, non-intravenous rescue benzodiazepines (non-IV-rBZDs) for febrile seizures and the factors associated with their prescription. MethodsRetrospective descriptive study using the MarketScan Commercial Database, a large database of employer-sponsored privately insured patients in the United States. We used data from January 1st 2006 to December 31st 2022. We studied patients with febrile seizures as the main code for the healthcare encounter (identified with International Classification of Diseases codes) with age from 6 months to 5 years of age and with at least 1 month of follow-up. ResultsThere were a total of 82,835 patients [median (p25-p75) age 1.0 (1.0–2.0) years, 56.7 % males] with at least one febrile seizure, of whom 9,737 (11.8 %) filled at least one non-IV-rBZD prescription. Among the 9,737 patients who filled at least one prescription, the median (p25-p75) time from first febrile seizure to non-IV-rBZD prescription was 27 (2–186) days. Among the factors known at the time of the first febrile seizure, complex febrile seizure (OR: 3.51, 95 % CI: 3.24–3.79), and an initial inpatient hospitalization for febrile seizure (OR: 3.53, 95 % CI: 3.29–3.79) were the factors most strongly associated with filling a non-IV-rBZD prescription. In contrast, sex, rural patient's residence, and salary employment (versus other employment class) were not independently associated with filling a non-IV-rBZD prescription. Among the factors known at the end of follow-up, complex febrile seizures, type of initial encounter, and an eventual diagnosis of epilepsy were major independent factors associated with filling a non-IV-rBZD prescription. ConclusionOnly approximately 12 % of children with a febrile seizure filled a prescription for a home non-IV-rBZD. The major factors independently associated with prescription were complex febrile seizure, hospital admission, recurrent febrile seizures, and an eventual diagnosis of epilepsy.

Analysis of Inflammatory Markers and Electroencephalogram Findings in Pediatric Patients with COVID-19: A Single-Center Study in Korea

Purpose: The Omicron variant wave spread rapidly from February 2022 in South Korea following the initial management of the coronavirus disease 2019 (COVID-19) outbreak. This study examined electroencephalogram (EEG) findings and serological inflammatory markers in pediatric patients with COVID-19 (Omicron variant).Methods: We retrospectively reviewed the medical records of 41 patients who presented at Gyeongsang National University Changwon Hospital between March and May 2022 and were diagnosed with COVID-19. All serological tests were performed within 24 hours of fever or seizure onset. Results: The median patient age was 3.6 years (range, 0.08 to 14.00), and the average hospital stay was 3.7 days (range, 1.0 to 7.0). Interleukin-6 (IL-6) levels were elevated above the normal range in all patients (median, 43.18 pg/mL; range, 7.0 to 190.0) and were higher among those who experienced seizures. Of the 41 total patients, 17 (41.5%; mean age, 5.4 years) visited the clinic for seizure. Three patients experienced prolonged seizures (lasting longer than 30 minutes) and received intravenous lorazepam, while eight presented with complex febrile seizures. Nine patients underwent EEG, of whom five exhibited abnormal initial findings. Linear regression demonstrated correlations between prolonged seizure duration and both serum IL-6 level and blood lymphocyte count.Conclusion: Numerous serological markers associated with the immune cascade were found to be elevated in children with COVID-19. Nevertheless, febrile seizures represent a relatively common neurological presentation among pediatric patients infected with Omicron variants. Consequently, COVID-19 infection exhibits both familiar and distinct characteristics regarding the mechanisms inducing seizures and fever in children.

SCN1A-Characterization of the Gene's Variants in the Polish Cohort of Patients with Dravet Syndrome: One Center Experience.

The aim of this study was to characterize the genotype and phenotype heterogeneity of patients with SCN1A gene mutations in the Polish population, fulfilling the criteria for the diagnosis of Dravet syndrome (DRVT). Particularly important was the analysis of the clinical course, the type of epileptic seizures and the co-occurrence of additional features such as intellectual disability, autism or neurological symptoms such as ataxia or gait disturbances. Based on their results and the available literature, the authors discuss potential predictors for DRVT. Identifying these early symptoms has important clinical significance, affecting the course and disease prognosis. 50 patients of the Pediatric Neurology Clinic of the Institute of Mother and Child in Warsaw clinically diagnosed with DRVT and carriers of SCN1A pathogenic variants were included. Clinical data were retrospectively collected from caregivers and available medical records. Patients in the study group did not differ significantly in parameters such as type of first seizure and typical epileptic seizures from those described in other studies. The age of onset of the first epileptic seizure was 2-9 months. The co-occurrence of intellectual disability was confirmed in 71% of patients and autism in 18%. The study did not show a correlation between genotype and phenotype, considering the severity of the disease course, clinical symptoms, response to treatment, the presence of intellectual disability, autism symptoms or ataxia. From the clinical course, a significant problem was the differentiation between complex febrile convulsions and symptoms of DRVT. The authors suggest that parameters such as the age of the first seizure, less than one year of age, the onset of a seizure up to 72 h after vaccination and the presence of more than two features of complex febrile seizures are more typical of DRVT, which should translate into adequate diagnostic and clinical management. The substantial decrease in the age of genetic verification of the diagnosis, as well as the decline in the use of sodium channel inhibitors, underscores the growing attention of pediatric neurologists in Poland to the diagnosis of DRVT.

Neurofilament Light Chain Concentration in Cerebrospinal Fluid in Children with Acute Nontraumatic Neurological Disorders.

(1) Introduction: This pilot study aimed to analyze neurofilament light chain levels in cerebrospinal fluid (cNfL) in a cohort of children with different acute nontraumatic neurological conditions. (2) Methods: This prospective observational cohort study consisted of 35 children aged 3 months to 17 years and was performed from November 2017 to December 2019. Patients' clinical data were reviewed, and patients were assigned to the following groups: n = 10 (28.6%) meningitis, 5 (14.3%) Bell's palsy, 7 (20.0%) febrile non-CNS infection, 3 (8.6%) complex febrile seizure, 4 (11.4%) idiopathic intracranial hypertension, and 6 (17.1%) others. cNfL levels were measured using a sensitive single-molecule array assay. (3) Results: The cNfL levels [median (range)] in children with meningitis were 120.5 pg/mL (58.1-205.4), in Bell's palsy 88.6 pg/mL (48.8-144.5), in febrile non-CNS infection 103.9 pg/mL (60.1-210.8), in complex febrile seizure 56 pg/mL (53.2-58.3), and in idiopathic intracranial hypertension 97.1 pg/mL (60.1-124.6). Within the meningitis group, children with Lyme neuroborreliosis (LNB) had significantly higher cNfL concentrations (median 147.9 pg/mL; range 87.8-205.4 pg/mL) than children with enterovirus meningitis (72.5 pg/mL; 58.1-95.6 pg/mL; p = 0.048) and non-significantly higher cNfL levels when compared to Bell's palsy (88.6 pg/mL; 48.8-144.5 pg/mL; p = 0.082). There was no correlation between cNfL levels and age. (4) Conclusions: Although the number of patients in this pilot study cohort is limited, higher cNfL levels in children with LNB compared to those with viral meningitis (significant) and Bell's palsy (trend) may indicate the potential of cNfL as a biomarker in the differential diagnosis of pediatric meningitis and facial palsy.

Analysis of three Chinese pedigrees affected with Genetic epilepsy with febrile seizures plus due to variants of SCN1A gene

To analyze the clinical and genetic characteristics of three Chinese pedigrees affected with Genetic epilepsy with febrile seizures plus (GEFS+). Three GEFS+ probands and their pedigree members presented at the Children's Hospital of Zhengzhou University from January 2020 to December 2021 were selected as the study subjects. Clinical data of the pedigrees were collected. Whole exome sequencing was carried out for the probands, and Sanger sequencing was used to verify the candidate variants. Proband 1 was a 3-year-and-2-month-old male with febrile seizure plus. His father, two aunts, grandmother, aunt grandmother, uncle grandfather, and paternal great-grandmother also had onset of febrile seizures at 1 ~ 2 years of age with remission before 6 years old. Proband 2 was a 1-year-and-4-month-old male with complex febrile seizure. His mother, maternal uncle, and maternal grandmother also had febrile seizures before 5 ~ 6 years of age. Proband 3 was a 3-year-and-11-month-old male with febrile seizure plus. His father and grandfather also had febrile seizures plus with remission at 7 ~ 8 years of age. Genetic testing revealed that proband 1 had harbored a paternally derived heterozygous SCN1A: c.1613T>C variant, proband 2 had harbored a maternally derived heterozygous SCN1A: c.2804A>G variant, and proband 3 had harbored a paternally derived heterozygous SCN1A: c.1271T>C variant. All of the three variants were predicted as likely pathogenic based on the guidelines from the American College of Medical Genetics and Genomics (PM1+PM2_Supporting+PP1+PP3+PP4). The c.1613T>C, c.2804A>G and c.1271T>C variants probably underlay the pathogenesis of GEFS+ in these pedigrees.

Racial and Ethnic Differences in Hospital Admission and Diagnostic Evaluation for Febrile Seizures in the Emergency Department

ObjectiveTo examine differences in hospital admission and diagnostic evaluation for febrile seizure by race and ethnicity. Study designWe conducted a cross-sectional study among children 6 months to 6 years with simple or complex febrile seizure between January 1, 2016, and December 31, 2021, utilizing data from the Pediatric Health Information System. The primary outcome was hospital admission. Secondary outcomes included the proportion of encounters with neuroimaging or lumbar puncture. We used mixed-effects logistic regression model with random intercept for hospital and patient to estimate the association between outcomes and race and ethnicity after adjusting for covariates, including seizure type. ResultsIn total, 94,884 encounters were included. Most encounters occurred among children of non-Hispanic White (37.0%), Black (23.9%), and Hispanic/Latino (24.6%) race and ethnicity. Black and Hispanic/Latino children had 29% (aOR 0.71; 95% CI: 0.66, 0.75) and 26% (aOR 0.74; 95% CI: 0.69, 0.80) lower odds of hospital admission compared with non-Hispanic White children, respectively. Black and Hispanic/Latino children had 21% (aOR 0.79; 95% CI: 0.73, 0.86) and 22% (aOR 0.78; 95% CI: 0.71, 0.85) lower adjusted odds of neuroimaging compared with non-Hispanic White children. For complex febrile seizure, the adjusted odds of lumbar puncture was significantly higher among Asian children (aOR 2.12; 95% CI: 1.19, 3.77) compared with non-Hispanic White children. There were no racial differences in the odds of lumbar puncture for simple febrile seizure. ConclusionsCompared with non-Hispanic White children, Black and Hispanic/Latino children with febrile seizures are less likely to be hospitalized or receive neuroimaging.

Febrile Seizures: An Updated Narrative Review for Pediatric Ambulatory Care Providers.

While generally self-limited, febrile seizures result in significant familial distress. Ambulatory pediatric care providers must be prepared to counsel families on the causes, risk factors, management principles, and prognosis of children with febrile seizures. To provide an updated, evidence-based review of febrile seizures focused on the needs of an ambulatory pediatric care provider. A narrative review of the literature prioritizing landmark articles, metanalyses, longitudinal population longitudinal cohort studies and national level guidelines. Febrile seizures are aberrant physiological responses to fever in children caused by complex interactions of cytokine mediated neuroinflammation, environmental triggers, and genetic predisposition. Other than investigations to determine fever etiology, routine bloodwork, lumbar punctures, neuroimaging and electroencephalograms are low yield. The general prognosis is excellent, however, clinicians should be aware of long-term outcomes including: cognitive impairment with non-simple febrile seizures; neuropsychiatric associations; recurrent febrile seizure and epilepsy risk factors; and the association between complex febrile seizures and sudden unexpected death. Children with a high risk of recurrence, complex febrile seizures, limited access to care, or extreme parental anxiety may benefit from intermittent oral diazepam prophylaxis. Clinicians should consider four management priorities: 1) terminating the seizure; 2) excluding critical differential diagnoses; 3) investigating fever etiology; and 4) providing adequate counselling to families. The clinical approach and prognosis of febrile seizure can be based on subtype. Children with non-simple (i.e. complex or febrile status epilepticus) febrile seizures require closer care than the vast majority of children with simple febrile seizures, who have excellent outcomes.

Etiological and risk factors in recurrent febrile seizures: Insights through EEG analysis.

Febrile seizures, convulsive episodes in young children during febrile illnesses, are a significant concern due to their potential for recurrence and associated uncertainties. This study investigated the causes and risks associated with recurrent febrile seizures and the critical role of electroencephalogram (EEG) in their accurate diagnosis. Following Institutional Review Board approval and going through the consenting process with parents, this study gathered the clinical features and EEG recordings of children admitted with febrile seizures in the Department of Pediatrics, Mahatma Gandhi Memorial Hospital, Kakatiya Medical College, Warangal, Telangana, India. Descriptive statistics, including mean, standard deviation (SD), frequencies, and percentages, were computed to understand the data comprehensively. The Chi-Square test was employed to analyze the association between variables, with a significance level of 0.05, ensuring reliable and trustworthy findings. Out of 42 children studied, 28 (66.67%) presented with simple febrile seizures, with the mean time of occurrence of seizures from the onset of fever being 7.85 hours. Abnormal EEG was seen in 50% of children with complex febrile seizures and 16% with simple febrile seizures. Generalized epileptiform discharges were the most common epileptic activity observed. Low sodium levels had a significant relationship with febrile seizures in the analysis. This study emphasizes the importance of EEG in diagnosing febrile seizures, particularly in complex cases. Our findings suggest that low sodium levels may be a significant risk factor for febrile seizures. Further research is necessary to identify other preventable risk factors to reduce the burden of the medical condition.

Neutrophil-lymphocyte ratio, red cell distribution width and mean platelet volume as practical markers in febrile seizure classification.

To examine the neutrophil-lymphocyte ratio, red cell distribution width and mean platelet volume in patients with febrile seizure and to determine their role in febrile seizure classification. This was a retrospective hospital-based study conducted among patients aged 5 to 72 months admitted with febrile seizure. Children who had febrile seizures due to upper respiratory tract infection were included in the study. The children were divided into two groups: simple febrile seizures and complex febrile seizures. Patients with a history of febrile status epilepticus, previous convulsions, use of antiepileptic or other chronic drugs, foci of infection other than the upper respiratory tract infection, abnormal biochemical parameters, and chronic mental or physical disease were excluded from the study. Clinical and laboratory findings of the patients were obtained from digital medical records. The records of 112 febrile seizure patients were reviewed, and 89 were grouped as simple and 23 as complex febrile seizures. Although there was no statistically significant difference between the two groups in terms of the mean red cell distribution width values (p=0.703), neutrophil-lymphocyte ratio and mean platelet volume were significantly higher in patients with complex febrile seizures (p=0.034, p=0.037; respectively). This study showed that neutrophil-lymphocyte ratio and mean platelet volume could be practical and inexpensive clinical markers for febrile seizure classification. A similar result could not be reached for red cell distribution width in this study. These findings should be supported by multicenter studies with large samples.

A preliminary study on the association between prognostic nutritional index and neutrophil-to-lymphocyte ratio with nutritional status and inflammation in febrile children's susceptibility to seizures.

The aim of this study was to evaluate the association between nutritional status, inflammation, and susceptibility to seizures in febrile children. This observational single-center study was carried out from January 2020 to December 2023 with 324 children aged 6 months and 6 years; 106 were diagnosed with febrile seizure, 108 were febrile children, and 110 were healthy controls. The prognostic nutritional index and neutrophil-to-lymphocyte ratio were calculated, and the cutoff threshold was established through receiver operating characteristics. The study utilized correlation and univariate-multivariate logistic regression analysis. The comparison between simple and complex febrile seizure was conducted to analyze differences. The optimal cutoff values were identified as 61.25 for prognostic nutritional index and 1.04 for neutrophil-to-lymphocyte ratio. Our findings showed a significant negative association between febrile seizure and platelet count, high C-reactive protein, and high ferritin levels. Additionally, the febrile seizure group showed a significant positive correlation with high neutrophil-to-lymphocyte ratio values (≥1.04) and body temperature (≥38). Our findings revealed that high neutrophil-to-lymphocyte ratio, high C-reactive protein, and age less than 18 months were independently associated with seizure susceptibility in febrile children. High neutrophil-to-lymphocyte ratio values and low prognostic nutritional index scores may serve as novel surrogate independent factors for seizure susceptibility in febrile children. Febrile children who are less than 18 months old are more prone to experience seizures than older febrile children. Moreover, there was a correlation between febrile seizures and elevated C-reactive protein levels and neutrophil-to-lymphocyte ratio values.

Evaluation of Iron Status in Children Presenting with Febrile Seizure in a Tertiary Health-care Facility

Abstract Introduction: The aim of this study was to investigate the relationship between iron deficiency anemia (IDA) and febrile seizures (FS) in children. Materials and Methods: The study included 100 cases of FS in children between the ages of 6 and 60 months, including both simple and complex FS. Children in the same age range who had a fever but no seizures made up the control group. The various hematological parameters reflecting the iron status, including hemoglobin (Hb), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), red-cell distribution width (RDW), serum ferritin, and total iron-binding capacity (TIBC), were evaluated in both groups to ascertain the relationship between the iron status and the FS. Results: Male-female ratio in children with and without FS were 1.2:1 and 1.3:1, with a mean age of 25.16 ± 11.75 and 24.37 ± 11.75 months, respectively. Age and gender distribution were comparable between the two groups (P = 0.719 and P = 0.851, respectively). The mean values for Hb, MCV, MCHC, RDW, ferritin, and TIBC among children who had FS were 11.030.98 g/dL, 66.1810.97 fl, 32.421.38 pg/L, 14.881.13, 46.5432.64 ng/mL, and 419.7672.49 g/dL, respectively. In contrast, the readings for the control group’s children were 11.91 0.78, 67.94 11.06 fl, 32.80 0.60 pg/L, 14.16 1.01, 59.20 27.52 ng/mL, and 378.65 60.87 g/dL, respectively. Except for the mean MCV, each of these variances was statistically significant. Conclusions: Our results suggest that IDA is a major risk factor for FS since it was more common in the case group than in the control group.

Clinical Significance of Lumbar Puncture in Children with First Febrile Seizures.

To evaluate the need for lumbar puncture (LP) in children aged 6 to 60 months experiencing their first febrile seizure, regardless of seizure type, and to determine if LP is particularly beneficial for those under 12 months old. In this retrospective study, data from 253 children who presented with first febrile seizure were analyzed. All patients in this study underwent LP and were divided into two groups based on their cerebrospinal fluid (CSF) results: non-pleocytosis and pleocytosis. Patients were evaluated for age, sex, familial history of seizure, and type and duration of seizures. They were also evaluated based on laboratory results, including blood tests, CSF analysis, and electroencephalography. Sixty-seven (25.9%) of the 253 patients were under 12 months of age, and only two of the 67 patients (2.8%) had pleocytosis. Patients younger than 12 months did not have a higher rate of complex febrile seizure or pleocytosis than those over 13 months of age. None of the patients had bacterial meningitis. Regarding viral meningitis, seven patients (5.3%; age mean SD, 12.3±1.8 months) were diagnosed with enteroviral meningitis, though only one of them had pleocytosis. When compared to the non-pleocytosis group, the pleocytosis group showed no differences in clinical characteristics (age, sex, familial history of seizure, type, and duration of seizure), laboratory results, or the use of antiepileptic drugs. The present study suggests that LP should be carefully considered in children with first febrile seizure, including children under 12 months of age.

The relationship between febrile seizure and hematological parameters in children

Aim: The aim of this study was to investigate whether hematological parameters play a significant role in the relationship between hematological parameters and seizure occurrence in children with febrile seizures (FS) by comparing them to a healthy control group with no fever or seizures. Materials and Methods: One-hundred forty-one patients diagnosed with FS and with available a complete blood count results and a control group of 143 children were finally enrolled. Results: The study group consisted of 141 patients, 57 girls (40.4%) and 84 boys (59.6%) (M/F=1.4). Mean age at the time of first FS was 22.89 ± 13.95 months. Ninety-two (65.2%) of the study group were diagnosed with simple FS, 32 (22.7%) with complex FS, and 17 (12.1%) with febrile status epilepticus (FSE). Conclusion: Since our neutrophil, lymphocyte, eosinophil, and mean platelet volume (MPV) results were statistically significant in patients with FS, it is thought that these markers may represent potential predictive parameters in that condition.