Febrile Seizure Group Research Articles

ROLE OF SERUM ZINC LEVEL IN CHILDREN WITH FEBRILE CONVULSIONS

Background: The aim of the present study was to determine whether there were any changes in serum zinc level in children with febrile seizure in comparison with febrile children without seizure.
 Methods: A prospective observational study was done on 100 children, admitted in a tertiary care centre. Of these 50 children were diagnosed to have febrile convulsions. The other 50 were febrile children without seizures. Serum zinc levels were measured in all 100 subjects using calorimetric methods. Data was analyzed using SPSS version 22.
 Results: In present study, we studied 50 children (36 males, 14 females) with febrile seizure and a control group of 50 patients (37 male, 13 female). The mean ages of patients in the febrile seizure and control group were 25.01±14.07 months and 26.07±13.6 months, respectively. Mean zinc level was 69.78±13.13mcg/dl and 80.72±10.21 mcg/dl in study and control groups respectively and this difference was found statistically highly significant (p<0.001).
 Conclusion: Our findings revealed that serum zinc level was significantly lower in children with febrile seizure in comparison with children without seizure.
 Keywords: febrile seizure, children, epilepsy.

Prospective case control study of iron deficiency and the risk of febrile seizures in children in South Korea

BackgroundFebrile seizures are the most common type of seizure in the first 5 years of life, and many factors that increase seizure risk have been identified. This study was performed to examine the association between iron status and febrile seizures in children in South Korea.MethodsA prospective unmatched case control study was performed in 63 cases of febrile seizures and 65 controls with febrile illness but no seizures.ResultsSerum iron, plasma ferritin, and transferrin saturation were significantly lower in children with febrile seizures compared to the controls. Iron deficiency, defined as ferritin < 30 ng/mL, was more prevalent in the febrile seizure group (49.2%) than in the control group (16.9%). Serum iron < 22 ng/dL (odds ratio 3.42, 95% confidence interval [CI] 1.31–8.9, P = 0.012) and ferritin < 30 ng/mL (odds ratio 6.18, 95% CI 2.32–16.42, P < 0.001) were associated with increased risk of developing febrile seizures in multivariate logistic regression analysis.ConclusionThese observations suggest that iron deficiency prior to development of anemia may increase risk of febrile seizures.

The association between iron deficiency anemia and febrile seizure.

Different studies have reported contradictory results regarding the relationship between iron deficiency anemia (IDA) and febrile seizure (FS). The present study was conducted to determine the effect of IDA on FS in children. This case-control study was conducted among 52 children with FS (the case group) and 18 children with afebrile seizures and 51 children with fever without seizures in the age range of 6 months to 5 years admitted to the pediatric ward of Imam Khomeini Hospital in Ilam from March 2016 to January 2017. Patients were selected using the convenience sampling method. Red blood cell (RBC) count as well as measurement of hemoglobin (Hb), hematocrit (Hct), ferritin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and mean corpuscular hemoglobin concentration (MCHC) levels were performed in all patients. The collected data were analyzed using SPSS16 software. A total of 34.6% in the FS group, 66.7% in the afebrile seizure group and 41.2% in the fever without seizure group suffered from IDA, which was not statistically significant between the three groups. Hb, Hct and RBC levels were higher in the case group and MCV, MCH, MCHC levels in the case group were lower than those in the control group. The odds ratio (OR) for FS compared to the febrile group was 0.756 [95% confidence interval (CI) = 0.34-1.68; p = 0.493] and that for FS compared to seizure was 0.265 (95% CI = 0.085-0.823; p = 0.022). This study showed that IDA may have protective effects on the onset of FS, and based on the results, IDA is more common in children with afebrile seizures. Further and more comprehensive studies are recommended.

Reduced cerebrospinal fluid levels of interleukin-10 in children with febrile seizures

PurposeThe exact etiology of febrile seizures (FS) is still unclear. However, it is thought that cytokine network activation may have a causative role. Therefore, this study aimed to evaluate the levels of interleukin-12 (IL-12) as a proinflammatory cytokine, interleukin-10 (IL-10) as an anti-inflammatory cytokine, and interferon-β (IFN-β), a marker of toll-like receptor-3 activation as a host response to viruses. These cytokine levels were analyzed in the cerebrospinal fluid (CSF) of children after a FS. MethodsWith the approval of the Human Research Ethics Committee, 76 patients with FS, who underwent lumbar puncture (LP) for the exclusion of central nervous system (CNS) infection, and who didn’t have CSF pleocytosis, were included in the study. The control group consisted of 10 patients with similar ages, with an acute febrile illness and who required LP to exclude CNS infection. The analyses were made by the enzyme-linked immunoassay method. ResultsAge, gender distribution and CSF IL-12 and IFN- β levels did not differ, but CSF IL-10 levels were significantly lower in the FS group as compared to the control group (0.78 ± 4.5 pg/ml, versus 27 ± 29 pg/ml, p < 0.0001). ConclusionThe low-level of CSF IL-10, considering its anti-inflammatory properties, may play a role in the etiopathogenesis of FS.

The role of Mean Platelet Volume/platelet count Ratio and Neutrophil to Lymphocyte Ratio on the risk of Febrile Seizure

Systemic inflammatory response has been implicated as a contributor to the onset of febrile seizures (FS). The four novel indices of the inflammatory response such as, neutrophil-to-lymphocyte ratio (NLR), mean platelet volume (MPV), platelet count (PLT) ratio and red blood cell distribution width (RDW) have been investigated in FS susceptibility and FS types (simple febrile seizure and complex febrile seizure). However, the potential role of these inflammatory markers and MPV/PLT ratio (MPR) in Chinese children with FS has yet to be fully determined. This study investigated the relevance of NLR, MPV, PLT, MPR and RDW in febrile children with and without seizures. 249 children with FS and 249 age matched controls were included in this study. NLR and MPR were calculated from complete blood cell counts prior to therapy. Differences in age, gender and these inflammatory markers between the FS group and the control group were evaluated using the chi-square test, t-test or logistic regression analysis. Receiver Operating Characteristic (ROC) curve was used to determine the optimal cut-off value of NLR and MPR for FS risk. Interactions between NLR and MPR on the additive scale were calculated by using the relative excess risk due to interaction (RERI), the proportion attributable to interaction (AP), and the synergy index (S). It has been shown that the elevated NLR and MPR levels were associated with increased risk of FS. The optimal cut-off values of NLR and MPR for FS risk were 1.13 and 0.0335 with an area under the curve (AUC) of 0.768 and 0.689, respectively. Additionally, a significant synergistic interaction between NLR and MPR was found on an additive scale. The mean levels of MPV were lower and NLR levels were higher in complex febrile seizure (CFS) than simple febrile seizure (SFS), and the differences were statistically significant. ROC analysis showed that the optimal cut-off value for NLR was 2.549 with 65.9% sensitivity and 57.5% specificity. However, no statistically significant differences were found regarding average values of MPR and RDW between CFS and SFS. In conclusion, elevated NLR and MPR add evidence to the implication of white cells subsets in FS risk, and our results confirmed that NLR is an independent, albeit limited, predictor in differentiating between CFS and SFS. Moreover, NLR and MPR may have a synergistic effect that can influence the occurrence of FS.

Possible Role of Heat Shock Protein 70 in Childhood Seizures

Abstract Background There has been a long interest in investigating the relationship between heat shock protein (HSP) expression and the evidence of neuronal damage in the most susceptible brain areas after seizures. So, the present study aimed to assess heat shock protein (HSP70) in children with seizures (febrile seizures and epilepsy), and to find out the cutoff point of this marker that may help in confirming epilepsy diagnosis. The present study has been conducted to evaluate serum levels of HSP70 in children with epileptic and febrile seizures and to compare these results to that of healthy children. Materials and Methods A prospective study included 85 children (32 females and 53 males) in Children and Maternity Unit, Minia University Hospital, Minia, Egypt. Children were subdivided into three groups, group (I) included 30 children with epilepsy, group (II) included 30 children with febrile seizures, and group (III) included 25 healthy children that served as a control group. HSP70 assay was performed for all included children using the enzyme-linked immunosorbent assay technique. Results The overall results revealed significant high serum HSP70 levels in epilepsy and febrile seizures groups when compared with control group (p &lt; 0.001). Also, HSP70 serum levels were significantly higher in epilepsy group than in febrile seizures group (p &lt; 0.001). Serum HSP70 level at a cutoff point &gt; 170 ng/L showed 60% sensitivity and specificity equal to 83.3% in prediction of epilepsy. Conclusion HSP70 level was significantly higher in epileptic and febrile seizures children than normal healthy children, and HSP70 may be beneficial in confirming the diagnosis of epilepsy.

SERUM ZINC LEVELS IN CHILDREN WITH SIMPLE FEBRILE SEIZURE

Background: It has been postulated that children with low serum zinc level are more prone to febrile seizures. Objectives: The objectives of this study were to compare the serum zinc levels in children suffering from febrile seizures with the children with febrile illness without seizures and children with no seizure and fever. Materials and Methods: A prospective case–control study was conducted in the Department of Pediatrics, in a Medical Institution of Meerut, over a period of 2 years (March 2015–May 2017). A total of 150 candidates of age 6 months–60 months were recruited from the pediatric wards and were divided into three subgroups. Group A consisted of 50 children who neither had fever nor seizures. Group B consisted of 50 children who had fever but no seizures. Group C consisted of 50 children who suffered from simple febrile seizure. Here, the Groups A and B served as control while Group C was taken as case. Serum zinc level was assessed in each child after taking written consent from parents. Further, the value of serum zinc was compared among the group. The results were statistically analyzed using the Statistical Package for the Social Sciences Version 21.0 statistical analysis Software. Results: Of 50 children with febrile seizures, 29 (58%) were male. Mean serum zinc levels of all the children included in the study were low (55.42 ?g/dl) as compared to the reference values. There was no significant difference in the serum zinc levels in the febrile seizure group and control groups. Conclusion: We found that the serum zinc level was not associated with febrile seizures.

Interleukin-4 and tumor necrosis factor-alpha levels in children with febrile seizures

PurposeThe pathophysiology of febrile seizures remains unclear. Cytokines have been suggested to play a role in the pathogenesis of febrile seizures. We compared TNF-α and IL-4 levels in patients with febrile seizure (FS) with those in controls and identified the relationship between cytokines and various other factors. MethodFifty FS patients who visited Konkuk University Hospital from December 2015 to December 2016 were included. Thirty-nine patients who had fever without seizures were enrolled as the control group. Serum samples from febrile patients with a history of febrile seizures without present seizures (FPH) (N = 12) and from the afebrile seizure (AF) group (N = 13) were also analyzed. In the FS group, we compared cytokine levels among patients stratified by sex, family history, seizure recurrence, duration of seizure and serum lactate levels. ResultsThe median serum TNF-α level in the FS group (19.54 pg/mL) was significantly higher than that in the control group (15.86 pg/mL). Higher median serum IL-4 levels were detected in the FS group (3.38 pg/mL) than in the control group (3.30 pg/mL). In the FS group, the serum IL-4 and TNF-α levels correlated with seizure recurrence and serum lactate levels, but they did not correlate with family history, duration of seizures or sex. ConclusionsOur study supports the hypothesis that TNF-α production is involved in the pathogenesis of febrile seizures. IL-4 is believed to be involved in the pathogenesis of febrile seizures. The number of seizures and lactate levels were correlated with IL-4 and TNF-α levels.

Serum Procalcitonin Levels in Acute Encephalopathy with Biphasic Seizures and Late Reduced Diffusion.

Procalcitonin (PCT) is used as a biomarker in severe infections. Here, we retrospectively investigated levels of serum PCT, C-reactive protein (CRP), and inflammatory cytokines (IL-6, TNF-α, and IFN-γ) in the second phase of patients with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD). Nine AESD pediatric patients (4 men, 5 women; AESD group) admitted to Okayama University Hospital from 2010 to 2016 were compared with 10 control patients with febrile seizures (FS) (3 men, 7 women; FS group). Mean PCT concentrations (ng/mL) in the AESD and FS groups were significantly different, at 9.8 ± 6.7 and 0.8 ± 0.9, respectively (p = 0.0006). CRP (mg/dL) were 0.79 ± 0.89 and 1.4 ± 1.0 (p = 0.94), respectively; IL-6 (pg/mL) were 449.7 ± 705.0 and 118.3 ± 145.4 (p = 0.20), respectively; TNF-α (pg/mL) were 18.6 ± 12.5 and 16.6 ± 6.0 (p = 0.67), respectively; and IFN-γ (pg/mL) were 79.6 ± 158.5 and 41.9 ± 63.7 (p = 0.56), respectively. Ratios of PCT to CRP were 27.5 ± 34.2 and 3.2 ± 6.8 (p < 0.0001), respectively. The sensitivity and specificity in the diagnosis of AESD using a cutoff of PCT/CRP ratio of 1.0 were 79% and 100%, respectively. These results suggest that PCT and the PCT/CRP ratio are useful in auxiliary diagnosis of the second stage of AESD, and in AESD, PCT is likely to increase through a different mechanism.

Long-term prognosis after childhood convulsive status epilepticus: a prospective cohort study

The prognosis of convulsive status epilepticus (CSE), a common childhood medical neurological emergency, is not well characterised. We aimed to investigate the long-term outcomes in a cohort of participants who previously had CSE. In this prospective study, we followed up a population-based childhood CSE cohort from north London, UK (the north London convulsive status epilepticus surveillance study cohort; NLSTEPSS). We collected data from structured clinical neurological assessment, neurocognitive assessment (Wechsler Abbreviated Scale of Intelligence), brain MRI, medical records, and structured interviews with participants and their parents to determine neurological outcomes, with adverse outcome defined as presence of one or more of epilepsy (active or in remission), motor disability, intellectual disability, or statement of special educational needs. We applied multiple imputation to address missing data and performed binary logistic regression analyses on complete-case and imputed datasets to investigate sociodemographic and CSE factors associated with adverse outcomes. Of 203 survivors (90% of inception cohort), 134 (66%) were assessed at a median follow-up of 8·9 years (IQR 8·2-9·5). The cumulative incidence of epilepsy was 24·7% (95% CI 16·2-35·6), with most (89%) emerging within 18 months after CSE. The cumulative incidence of epilepsy was lower in patients with prolonged febrile seizures (14·3%, 6·3-29·4) and survivors of acute symptomatic CSE (13·3%, 3·7-37·9) than in those of remote symptomatic CSE (45·5%, 21·3-72·0) and unclassified CSE (50·0%, 25·4-74·6). One participant (2·9%, 0·5-14·5) in the prolonged febrile seizures group developed temporal lobe epilepsy with mesial temporal sclerosis. The absence of fever at CSE was the only predictor of incident epilepsy (odds ratio [OR] 7·5, 95% CI 2·25-25·1). Motor and intellectual disability was seen predominantly in participants who had idiopathic and cryptogenic CSE (seven [36·8%, 95% CI 19·1-59·0] and 16 [84·2%, 62·4-94·5] of 19, respectively) and remote symptomatic CSE (33 [62·3%, 48·8-74·1] and 40 [75·5%, 62·4-85·1] of 53), and most of these participants had pre-existing disabilities. Pre-existing epilepsy was the only predictor of intellectual disability (OR 8·0, 95% CI 1·1-59·6). 51·5% (95% CI 43·1-59·8) of those followed up had a statement of special educational needs. Childhood CSE is associated with substantial long-term neurological morbidity, but primarily in those who have epilepsy, neurological abnormalities, or both before the episode of CSE. Survivors without neurological abnormalities before CSE have favourable outcomes. BUPA Foundation, The Academy of Medical Sciences, Wellcome Trust, National Institute for Health Research, and Young Epilepsy.

Effect of melatonin on cytokine levels in a hyperthermia-induced febrile seizure model.

Higher serum cytokine levels have been reported in children admitted with febrile seizures and in some experimental models. However, other studies have shown that cytokine levels are influenced by melatonin. In this study, we investigated serum cytokine levels in a hyperthermia-induced febrile rat seizure model and the effect of melatonin. A total of 28 male Sprague-Dawley rats were divided into four groups: the control (C) group, healthy melatonin (MT) group, and hyperthermia-induced febrile seizure groups with (HIFS-MT) and without (HIFS) administration of melatonin. Melatonin (80 mg/kg) was given intraperitoneally 15 min before the seizure. HIFS was induced by placing the rats in 45°C water. The rats were sacrificed under anesthesia after the seizure. Blood samples were drawn by transcardiac puncture to measure serum cytokine and melatonin levels. Serum interleukin (IL)-1β, IL-6, IL-10, and tumor necrosis factor (TNF)-α levels were lower in the HIFS group than those in the C group (p = 0.005, p = 0.200, p = 0.011, and p = 0.016, respectively). All serum cytokine levels of rats in the MT and HIFS-MT groups were similar to those in the C group. This experimental rat model demonstrated that serum cytokine levels decrease with HIFS and that administering melatonin maintains serum cytokine levels. These results suggest that cytokines may play role in the anticonvulsive activity of melatonin in rats with febrile seizures.

Analysis of plasma multiplex cytokines and increased level of IL-10 and IL-1Ra cytokines in febrile seizures

BackgroundFebrile seizures are the most common form of childhood seizures. Fever generation involves many cytokines, including both pro- and anti-inflammatory cytokines. Some of these cytokines also induce febrile seizures. We compared cytokine production in children with a fever alone (healthy control group) and febrile seizure children group. Also, we evaluated the cytokine level of children with a fever alone and febrile seizure history.MethodsFifty febrile seizure patients and 39 normal control patients who visited the emergency department of Konkuk University Hospital from December 2015 to December 2016 were included in this study. Blood was taken from the peripheral vessels of children in all groups within 1 h of the seizure, and serum was obtained immediately. Serum samples from patients with only a fever and a febrile seizure history (N = 13) and afebrile seizure controls (N = 12) were also analyzed.ResultsThe serum IL-10 and IL-1Ra levels were significantly higher in the febrile seizure patients than in the fever-only control, fever only with a febrile seizure history, and afebrile seizure groups (p < 0.05). The serum IFN-γ and IL-6 levels were significantly higher in the febrile seizure patients than in the afebrile seizure group (p < 0.05). The serum IL-8 levels were higher in the febrile seizure patients than in the fever only controls (p < 0.05).ConclusionsThe serum levels of the IFN-γ, IL-6, and IL-8 pro-inflammatory cytokines and the serum levels of the IL-10 and IL-1Ra anti-inflammatory cytokines were significantly higher in the febrile seizure children. Furthermore, the serum level of IL-1Ra was more increased in the febrile seizure group than in the same patients with only a fever. Our data suggest that increased serum IL-10 and IL-1Ra may play potential roles as anti-inflammatory cytokines in a compensation mechanism that shortens the seizure duration or prevents a febrile seizure attack. Therefore, anti-inflammatory cytokines, including IL-10 and IL-1Ra, have potential as therapeutic targets for the prevention of seizures and nervous system development of children.

Serum Prolactin Level in Children with Febrile Seizure and Epileptic Seizure; Comparative Study

Introduction: Transient hyperprolactinaemia has been reported to follow unprovoked seizures, a finding proposed to be useful in the differential diagnosis of epilepsy. On this basis we conducted a study with an objective to compare the postictal serum prolactin level in children with febrile seizures (FS) and epileptic seizures (ES) to evaluate, whether serum prolactin (PL) could be used a predictor in the diagnosis of ES.Material and Methods: This was a prospective comparative study was conducted on 52 children (26 in febrile seizures group and 26 in epileptic seizure group) in the age group of six months to five years. Children with CNS infection, developmental delay, structural CNS defects or neurological abnormality, metabolic disorders and those on drugs, known to have altered serum prolactin level were excluded. Blood for estimation of serum prolactin was collected within 180 minutes of occurrence of seizure. Level of serum prolactin was quantitatively assayed by chemiluminescence method and the levels were considered high, if values were greater than 23 ng/ml, which is the upper limit of normal for all age groups and both sex.Results: The mean serum prolactin level in epileptic seizures group was 25 ng/ml and that of febrile seizures group was 10.72 ng/ml. High level of serum prolactin was noted in 17 children (77.2%) with GTCS and 3 children (75%) with CPS. None of the children with febrile seizures had significant raise in the level of serum prolactin.Conclusion: There is a significant rise in serum prolactin level in children with epileptic seizures compared to febrile seizures, if measured within 3 hours of occurrence of seizures. Thus, the post-ictal serum prolactin level can be used as an additional investigation to diagnose or predict epileptic seizures in children.

Differences in the Levels of Interleukin-1β (IL-1β) and Interleukin-1 Receptor Antagonist (IL-1ra) in Children with Status Epilepticus and Febrile Seizure

Proinflammatory cytokines are elevated in status epilepticus and febrile seizure and associated with tissue damage. This study aimed to investigate the differences in interleukin 1 beta (IL-1β) and interleukin 1 receptor agonist (IL-1ra) levels in status epilepticus as compared with febrile seizure and febrile. This cross-sectional study was designed to include 45 subjects divided equally into three groups (status epilepticus, febrile seizure, and febrile). Both IL-1β and IL-1ra were measured by using an ELISA method. Results showed that IL-1β levels were significantly higher in the status epilepticus group as compared with the febrile seizure and febrile groups (p < 0.05). IL-1ra levels in the status epilepticus group were significantly lower compared with the febrile seizure group (p = 0.04). Consistently, the IL-1β/IL-1ra ratio in the status epilepticus group was significantly higher as compared with the febrile seizure group (p = 0.01). We concluded that IL-1β and the IL-1β/IL-1ra ratio were significantly higher in status epilepticus. IL-1ra levels were significantly higher in the febrile seizure group.

Relationship of Iron Deficiency Anemia with Simple Febrile Seizure in Children

Background and objective: Febrile Seizure (FS) is the commonest seizure disorder among under 5 children. Iron deficiency is a documented risk factor of FS and as the data about the relationship of iron deficiency with FS among Bangladeshi children is scanty, this study was undertaken to assess the association of Serum Ferritin to simple FS.Materials and Methods: This case control study was conducted at the department of pediatrics of SSMC &amp; Mitford Hospital during 7th May 2011 to 6th January 2012 on consecutive 120 children aged between five months to six years who fulfilled the inclusion criteria were considered as cases. Similar number of age and sex matched children admitted with fever without seizures were taken as controls. All candidates were gone through CBC with RBC indices and serum ferritin and iron deficiency anemia was diagnosed on the basis of mentioned tests.Results: The results showed that majority of the cases were male (66.7%) and most of them were between 13-24 months of age (51.7%). Mean duration of convulsion was less than 5 minutes in 70% of the cases. Level of Hb was low in both the cases and controls but the other RBC indices for anemia like MCV, MCH, MCHC and serum ferritin were significantly lower among the febrile seizures group in comparison to controls. The chi-square test is indicated as a significant difference between two groups and odds ratio is 6.0 which signifies that febrile seizure group were 6.0 times more likely to develop iron deficiency anemia compared to control group.Conclusion: The findings suggest that children with febrile seizure have association with iron deficiency anemia (which is evident by microcytic hypochromic anemia and low serum ferritin level) .This means low serum ferritin and presence of anemia can serve as a risk factor for febrile seizure in children.J Bangladesh Coll Phys Surg 2017; 35(2): 75-79

Electroencephalographic and biochemical long–lasting abnormalities in animal model of febrile seizure

Febrile seizures (FS) are convulsions associated with high body temperature. It has a high incidence in children from the age of 6months to 5years and may have adverse consequences in adulthood. The experimental model of FS could be induced in animals via hyperthermia. The present study was designed to investigate persistent electroencephalographic (EEG), neurochemical and behavioral alterations in adult animals that had experienced complex FS at their immature age. EEG signals were obtained from the cortex of both FS and control normothermic groups of animals. A spectrophotometric assay was carried out to determine oxidative stress parameters (malondialdehyde, nitric oxide, reduced glutathione) and acetylcholinesterase activity in the cortex and hippocampus of FS and control animals. Behavioral assessment of seizure threshold and severity were investigated via a sub–convulsive dose of nicotine in adult animals. Alterations in the oxidant/antioxidant system and AChE activity were obtained in the cortex and hippocampus of FS animals in comparison to control animals. EEG spectral analysis displayed significant changes in all EEG frequency bands. A decrease in seizure latency and an increase in seizure severity were also observed. The present study provides evidence for long-lasting abnormalities in the cortex and hippocampus of adult animals subjected to complex FS at their developmental age, which may be correlated to the underlying mechanism of epileptogenesis and its related co–morbidities.

Association between serum selenium levels and febrile seizures in Indian children: a case control study

Background: Febrile seizures are the most common form of childhood seizures. Children are at particular risk for selenium deficiency. There was various hypothesis about the co-relation between selenium levels and febrile seizures. The aim of the present study was to determine whether there were any changes in serum selenium levels in children with febrile seizures when compared to children with febrile illness without seizures.Methods: This was a hospital based prospective case control study, consisting of 40 children (20 cases and 20 controls) aged between 6 months to 60 months. The serum selenium level was measured in each of them by atomic absorption spectrophotometer. Data was analysed by using frequency percentage and pearson’s chi square test.Results: Out of the 40 children included in the study, serum selenium level was lower in febrile seizure group (80%) when compared to controls (20%) which was statistically significant (P value: 0.003). Also, there was no statistically significant difference between males and females.Conclusions: In the present study, we found significantly low serum selenium levels in children with febrile seizures as compared to the children with febrile illness with no seizures. Decreased levels of selenium in children with febrile seizures may be the result of oxidative damage, occurring in the neuronal cells. In our study, a significant co-relation between low levels of selenium and febrile seizures have been observed in children. However, since the numbers are small, further studies with larger sample size are recommended.

A study of evaluation of iron deficiency as a risk factor for febrile seizures

Objective: To estimate the incidence of seizure of iron deficiency anemia in febrile seizure. To determine the clinical correlates of children with febrile seizures. Methods: In this case, control study was conducted among 126 children of age group between 6 months and 5 years during April 2015 to April 2016. The control case groups were matched based on the family history of febrile seizure, age, sex, and temperature. Blood samples were collected. Measured quantities of serum feritin, hemoglobin, mean corpuscular volume and mean corpuscular hemoglobin were compared. Result: 36 children (28.5%) in the febrile Seizure group have positive family history when compared to none among controls. Serum ferritin level in febrile seizure group is found to have 14.5+/-10.6 ng/ml, where as in controls it is 34.9+/-23.3 ng/ml .The mean hemoglobin was 9.8+/-1.2 gm/dl whereas in controls, it was 11.3+/-1.1gm/dl. The mean corpuscular volume is 76+/-8.5fl, whereas in control it is 79.5+/-7.5fl, which was statistically significant. The mean corpuscular hemoglobin was 27.7+/-3.1pg and for control it was 28.7/3.6 pg. Conclusion: Serum ferritin, Hb% and MCV were found to be significant on the lower side in children with febrile seizure when compared to the children who did not have febrile seizure.

GABRG2 C588T gene polymorphisms might be a predictive genetic marker of febrile seizures and generalized recurrent seizures: a case-control study in a Romanian pediatric population.

IntroductionThis case-control study aimed to assess two single nucleotide polymorphisms of the gene encoding the GABRG2 protein – GABRG2 (3145 G>A) and GABRG2 rs 211037 Asn196Asn (C588T) – in a cohort of pediatric patients from Romania, and evaluate their possible impact on drug-resistant forms of generalized epilepsy and recurrent febrile seizures.Material and methodsOne hundred and fourteen children with idiopathic generalized epilepsy (group 1) or febrile seizures (group 2) were compared to 153 controls. Peripheral blood samples were assessed using polymerase chain reaction-restriction fragment length polymorphism analysis, with results interpreted based on the disappearance of a restriction site in the C allele (122 bp) compared to the T allele (100 bp + 22 bp).ResultsA significant association was found with the TT homozygous genotype and T allele for both febrile seizures and epilepsy for the C588T locus, while GABRG2 G>A 3145 showed no significant association with any type of seizure. The TT homozygous genotype of GABRG2 Asn196Asn polymorphism was more frequent in patients with a history of febrile seizures (p = 0.0001), without a significant association identified for GABRG2-G>A 3145. Composite analysis showed associations with epilepsy for CC-AG (p = 0.02) and CT-AG (p = 0.007) with the CC-AA combination as reference.ConclusionsC588T polymorphism of the GABRG2 gene might be a predictive genetic marker in triggering febrile convulsions. GABRG2 rs211037 TT homozygotes and T allele variants have an increased risk for developing febrile seizures. Recurrent crises and repeated episodes of seizures are more frequent in the GABRG2 Asn196Asn TT genotype polymorphism, with a 45 and 8 times higher risk of developing idiopathic generalized epilepsy and recurrent febrile seizures, respectively.

Urinary kidney injury molecules in children with febrile seizures

Objective: Hypoxia occurs following convulsions, and hypoxia is one of the most common causes of acute renal damage. The aim of this study was to investigate urinary levels of kidney injury molecules, including neutrophil gelatinase-associated lipocalin (NGAL), N-acetyl-β-D-glucosaminidase (NAG), and liver-type fatty acid-binding protein (L-FABP) in children with febrile seizures (FS) for the first time.Methods: The study included 28 children with FS and 34 age and gender matched healthy children. Serum biochemistry and blood gases were measured in the serum samples. Estimated glomerular filtration rate (eGFR) was calculated. NGAL, NAG, L-FABP, and creatinine (Cr) were measured in the urine samples. The ratios of kidney injury markers to urinary Cr were used for comparisons.Results: There were no significant differences in eGFR and serum chemistry values between the FS and the control group (p > 0.05). Hypoxia was detected in 67.9% of the FS patients. The FS group had significantly higher urinary kidney injury molecules to Cr ratios compared to the controls, including NGAL/Cr (17.9 ± 9.8; 6.7 ± 4.0, respectively; p < 0.001), NAG/Cr (0.55 ± 0.29; 0.21 ± 0.16, p < 0.001), and L-FABP/Cr (4.85 ± 2.93; 1.74 ± 1.16, p < 0.001).Conclusion: Increased urinary NGAL/Cr, NAG/Cr, and L-FABP/Cr values, in patients with FS compared to healthy controls, suggest a possible subclinical renal damage in these patients.