Occurrence Of Febrile Seizures Research Articles

Shining a Light on Trace Elements: A Systematic Review and Meta-analysis of Serum Concentrations in Febrile seizure.

Febrile seizures (FS) are a common occurrence in pediatric patients and are typically triggered by high fevers above 100.4°F (38°C), often associated with viral or bacterial infections such as respiratory or gastrointestinal infections. Recent research suggests that the serum concentration of trace elements may play a role in the occurrence of FS. This study aimed to assess the association between serum levels of trace elements and FS in pediatric patients. A comprehensive search of four databases, including Scopus, Web of Science, PubMed, and Google Scholar, was conducted up to February 2024. The study followed the PICO structure, focusing on the Population (pediatric patients with FS), Intervention (serum concentrations of selenium, zinc, magnesium, and copper), Comparison (with or without controls), and Outcome (occurrence of FS). The methodological quality of the included observational studies was assessed using the Newcastle-Ottawa Scale (NOS) tool. Out of a total of 168 papers, 37 met the inclusion criteria for this meta-analysis, covering studies published between 2018 and 2023. Lower serum zinc levels were observed in pediatric patients with FS compared to control groups (SMD: -1.25, 95% CI: -1.47, -1.03). Conversely, higher serum copper levels were found in control groups compared to those with FS (SMD: 0.43, 95% CI: 0.04, 0.82). Additionally, lower serum magnesium levels were detected in the FS group compared to controls (SMD: -0.76, 95% CI: -1.57, 0.05), while serum selenium levels were approximately two times lower in the FS group than in controls (SMD: -2.23, 95% CI: -2.76, -1.70). Our meta-analysis suggests that pediatric patients with FS have lower serum concentrations of trace elements compared to controls. Further research is warranted to elucidate the potential role of trace elements in the pathogenesis of FS. This meta-analysis and systematic review was registered in the International prospective register of systematic reviews (PROSPERO ID: CRD42024519163). Registry URL: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024519163 registry number: CRD42024519163.

The protective effect of breastfeeding on febrile seizures: a systematic review with meta-analysis.

Several potential risk factors have been identified in the etiopathogenesis of febrile seizures (FS), including the type and extent of breastfeeding (BF). Given the lack of conclusive data, this study aims to systematically evaluate the evidence on the association between BF and FS. We conducted a systematic review and meta-analysis according to PRISMA guidelines. The search was conducted using descriptors for FS, BF, and formula feeding in MEDLINE, Embase, and Web of Science databases. We included observational studies that compared the incidence of FS between those who had ever breastfed and those who were formula fed. The study protocol was registered on the PROSPERO platform under the number CRD42023474906. A total of 1,893,079 participants from 8 datasets were included. Our main analysis showed no significant association of any type of BF on the incidence of FS compared with formula-fed children (OR: 0.84; CI: 0.67-1.04; I2 = 78%; Cochran's Q = 0.0001), although meta-regression showed that BF was associated with a lower incidence of FS in preterm infants. Our secondary outcome showed a significantly reduced incidence of FS in children who received BF exclusively (OR: 0.80; CI: 0.65-0.99; I2 = 70%; Cochran's Q = 0.02). Conclusion: There was no significant reduction in the incidence of FS in those who were breastfed compared to formula feeding. However, our meta-regression analysis indicated an association between BF and a lower incidence of FS in preterm infants. Additionally, children who exclusively received BF had a significantly reduced incidence of FS. These findings should be further investigated in prospective cohorts. What is Known: • Breastfeeding can modify risk factors for febrile seizures, such as susceptibility to viral and bacterial infections, micronutrient deficiencies, and low birth weight. •However, studies have shown conflicting results regarding the impact of breastfeeding on febrile seizures. What is New: •When comparing any breastfeeding pattern with no breastfeeding, there is no significant difference in the incidence of febrile seizures. •When comparing exclusive breastfeeding with no breastfeeding, there may be a decrease in the occurrence of febrile seizures.

The Role of Molecular Aspects in the Occurrence of Febrile Seizures

Febrile seizures are the result of complex interactions between multiple molecular components in the child's central nervous system, including changes in neurotransmitters, neuronal activity, and the brain's inflammatory response. When a child has a fever, there is an increase in body temperature, which triggers a series of molecular changes in the brain, affecting electrical signaling pathways and triggering characteristic seizures. The literature search process was carried out on various databases (PubMed, Web of Sciences, EMBASE, Cochrane Libraries, and Google Scholar) regarding studies of molecular aspects of febrile seizures. This study follows the preferred reporting items for systematic reviews and meta-analysis (PRISMA) recommendations. An increase in body temperature (fever) is the main trigger for febrile seizures. Fever can result in changes in brain chemistry, including changes in neurotransmitters and inflammatory responses, which can affect the molecular pathways that trigger seizures. Glutamate is the main neurotransmitter that plays a role in triggering seizures. Increased glutamate release during fever can trigger excessive activity in neurons. On the other hand, GABA, a neurotransmitter that plays a role in dampening neuronal activity, may also be involved, and an imbalance between glutamate and GABA may occur during seizures. Genetic factors play a role in susceptibility to febrile seizures. Several genes, such as SCN1A and GABRG2, have been identified as potentially increasing the risk of febrile seizures, especially those of a complex nature. Febrile seizures usually do not cause permanent changes in brain structure. However, in some very rare cases, such as EASIFE, temporary changes in brain structure may occur.

Changes of serum metabolomics and gut microbiota reveal specific characteristics of children with febrile seizures.

Febrile seizures (FS) pose a severe threat to the neurological development of children. Probing the abnormality of host metabolism is essential for the prevention, diagnosis, and treatment of FS. Based on clinically collected serum and fecal samples, we used nontargeted metabolomics and 16S rDNA sequencing to explore the relationship of serum metabolite levels and gut microbiota community with the occurrence of FS. Metabolomic analysis revealed abnormalities in multiple metabolic pathways in serum of FS patients, such as tryptophan metabolism and steroid hormone biosynthesis. Intestinal flora analysis indicated that the α-diversity of gut microbiota in FS patients was significantly reduced. In addition, the relative abundance of a variety of bacteria at the phylum level was remarkably changed in patients with FS, including decreased Firmicutes and Verrucomicrobia. Eleven serum metabolites were identified to be biomarker candidates for FS diagnosis. With the help of a panel biomarker strategy combining four biomarkers as a cluster, four bacteria (i.e., Rothia, Coprococcus, Lactobacillus, and Oscillospira) in a defined panel displayed perfect differentiation of subtypes of FS. Combining metabolomic and intestinal flora analysis revealed specific characteristics of children with FS, and provided new clues for the diagnosis of FS and the classification of seizure types. In summary, these findings may provide new insights into revealing the significance of serum metabolites and gut microbiota in the pathogenesis of FS.

Serum hypomagnesemia is associated with febrile seizures in young children.

Febrile seizures (FS) frequently manifest in children below 5 years of age. Although the exact etiology is still unknown, genetic predisposition, changes in neurotransmitter levels, and serum electrolyte imbalance are some of the known risk factors. This study examined the possible association between serum magnesium levels in children with FS compared to febrile children without seizures. A retrospective case-control study was conducted from February 2019 to January 2021, recruiting 230 age and gender-matched cases and controls (115 each). Extracted data were analyzed using SPSS using an independent student's t-test, Chi-square test, and Pearson's correlation analysis. The mean serum magnesium levels were 0.93 ± 0.129 vs 0.97 ± 0.0961; p < 0.001, between cases and controls respectively. Similarly, hypomagnesemia (<0.85 mmol/L) was detected in 26.1% and 8.7% of the cases and controls, respectively; p < 0.001. A significant negative correlation was found between serum magnesium levels and the occurrence of febrile seizures; r = [-0.169], p < 0.05. Serum magnesium was significantly low in febrile children with seizures compared to those without, and hypomagnesemia was associated with the occurrence of febrile seizures. These results portray hypomagnesemia as a possible risk factor for febrile seizure, and so should be validated in future large cohort studies so that guidelines are set for proper management of these children.

KCC2 rs2297201 Gene Polymorphism Might be a Predictive Genetic Marker of Febrile Seizures.

Introduction: Febrile seizures (FS) are the most common neurological disease in childhood. The etiology of FS is the subject of numerous studies including studies regarding genetic predisposition. Aim: The aim of the study was to analyze the association of TRPV1 rs222747 and KCC2 rs2297201 gene polymorphisms with the occurrence of FS. Materials and Methods: The study included 112 patients diagnosed with FS classified as simple febrile seizures (SFS) or complex febrile seizures (CFS). We analyzed selected polymorphisms of KCC2 and TRPV1 genes using the Real-time PCR method. Results: The CT and TT genotypes of the rs2297201 polymorphism of the KCC2 gene are significantly more common in the group of children with FS than the control group (p = .002) as well as the allele T of this polymorphism (p = .045). Additionally, genotypes CT and TT of the rs2297201 polymorphism of the KCC2 gene were more frequent in the group of children with CFS compared to the control group (p < .001). Different genotypes and alleles of the rs222747 TRPV1 gene polymorphism were not associated with the occurrence of febrile seizures or epilepsy, nor were associated with the occurrence of a particular type of febrile seizure (p = .252). Conclusion: These results indicate that the CT and TT genotypes, as well as the T allele of rs2297201 polymorphism of the KCC2 gene, could be a predisposing factor for the FS, as well as the occurrence of CFS.

Febrile Seizures in Thalassemic Patients in Babylon Teaching Hospital for Maternity and Children

Febrile seizures are the most common seizures in children. Their incidence is (2-5 %). To date, thepathophysiology of febrile seizures is unknown. But several hypotheses have been supposed that itmay relate with plasma iron level. Such low risk in thalassemic patients whose plasma iron level is highcould give some clues to this hypothesis.Aim of the Study: Determine the risk of febrile seizure in thalassemic patients in comparism with thecorresponding control group.Patients and Methods: This case –control study was conducted on one hundred fifty patients withthalassemia major between six month and six years of age who were visit Babylon center for inheritedblood diseases in the Teaching hospital for maternity and children from April 2019 to January 2020.All medical records of thalassemic patients were thoroughly reviewed and the occurrence of febrileseizures are interviewed and compared with the control group .The children in the control group areneither thalassemic nor has iron deficiency anemia.Results: Febrile seizure was detected in one case of the thalassemic group (0.66%) versus six cases(4%) of the control group. The risk of febrile seizure in the control group was 6 times more than that inthe thalassemia group, which was statistically significant (P =0.036).Conclusion: The risk of febrile seizures in thalassemic patients was (0.16) that of the general childrenpopulation. Thus, iron overload may be a major factor involving the brain metabolism that preventsfebrile seizures.

Risk Factors for Febrile Seizures in Children Aged 6 – 59 Months in Surabaya, East Java

Background: Febrile seizures are common in children under 5 years of age. Parents are concerned when their children have seizures; therefore, it is necessary to provide promotive and preventive education regarding the risk factors for febrile seizures so that parents are more prepared. This study aimed to explore the risk factors for febrile seizures in children. Methods: This case-control study was conducted on 170 children. Sampling was carried out by purposive sampling on inpatients and/or outpatients at the Pediatric Department Dr. Ramelan Naval Hospital Surabaya during May 2019-July 2020. Secondary data for children with fever were retrieved from medical records, with seizures (n85) and without seizures (n85) as a control group. Furthermore, data on temperature, age, birth weight, and history of asphyxia were analyzed and compared, using the chi-square test or Fisher’s exact test. Results: There was a significant difference between the case and control groups regarding the history of asphyxia and the occurrence of febrile seizures (p=0.002; OR=26.39; and 95% CI 1.52-455.62). There was no significant difference between the risk factors for high temperature (p=0.12), age (p=0.52), or birth weight (p=0.37) with the occurrence of febrile seizures. Conclusions: A history of asphyxia in children under five years is a risk factor for febrile seizures. Appropriate education from health professionals can help parents improve their knowledge, attitudes, and practices in dealing with febrile seizures and their risk factors.

Disproportionality analysis of reported drug adverse events to assess a potential safety signal for pentavalent vaccine in 2019 in El Salvador

Detection and surveillance of vaccine safety hazards is a public health staple. In the post-marketing phase, when vaccines are used in mass, it is crucial to monitor potential signals of adverse reactions that may have been missed in the pre-marketing phase. We analysed spontaneous reports of drug adverse events in El Salvador to assess a potential safety signal related to an increase in febrile seizures following the pentavalent (diphtheria, tetanus, pertussis, hepatitis B, and Haemophilus influenzae Type B) vaccine in 2019.This was a retrospective observational study of adverse event notifications in the national electronic drug safety database from 2011 to 2019. We performed standard disproportionality analysis computing Proportional Reporting Risk (PRR), Reporting Odds Ratio (ROR), Relative Reporting Ratio (RRR), Chi-squared, and Information Component (IC), comparing the pairing of febrile seizures and pentavalent vaccine to all other drugs and adverse events recorded in 2019.The occurrence of febrile seizures following pentavalent vaccination exceeded the WHO expected rate of six cases × 100 000 doses administered from April 2019, with a maximum of 9.2 in September. IC was 4.3, ORR 421.9 (95% Confidence Interval, CI: 123.8–1437.7), PRR 223.5 (95 %CI: 70.2–710.9), RRR was 19.5. The first booster presented the highest rate (14.6 per 100,000 doses) of febrile seizures, more than double than expected. Rates for 2018 remained below expected. Reports of febrile seizures following pentavalent vaccine were also on the increase globally since 2014, with highest rates in 2018 and 2019.There was a disproportion of febrile seizures notifications following pentavalent in El Salvador in 2019, suggesting the existence of a safety signal. This may be due to the change in provider. Further studies should assess the causes of the increase and compute costs and benefits of this vaccination to determine if switching to a less reactogenic vaccine formulation is indicated.

Mean Platelet Ratio, Neutrophil to Lymphocyte Ratio, and the Risk of Febrile Seizures in Children Aged 6–59 Months

BACKGROUND: The occurrence of febrile seizure is affected by numerous factors, but some studies indicated that inflammatory cytokines might contribute to the development of febrile seizure. In resource limited settings, complete blood count (CBC) might serve as potential indices for inflammatory response. AIM: The aim of the present study was to determine the role of mean platelet ratio and neutrophil to lymphocyte ratio (NLR) on the risk of febrile seizures in children aged 6–24 months and 25–59 months at S.K. Lerik Regional Public Hospital in Kupang City, East Nusa Tenggara, Indonesia. METHODS: A case-control study was carried out in 104 patients (52 in the case group and 52 in the control group) aged 6–59 months. The CBC tests were taken on the first visit in the emergency room at S.K. Lerik Regional Public Hospital. RESULTS: Our study found that the odds for experiencing febrile seizure in younger children aged 6–24 months were 3.281 (95% confidence interval 1.470, 7.324) times as large as the odds for older children aged 25–59 months. There was a significant but weak correlation between the types of febrile seizure or fever and age of children (r = 0.279; p = 0.012). CONCLUSIONS: Children aged 6–24 months had higher risk of developing febrile seizure, compared to children aged 25–59 months. Further, for each unit decrease in NLR, we expected a 0.883 decrease in the odds for febrile seizures in the case group, compared to control group.

Relationship between Neonatal Asphyxia and Exclusive Breastfeeding with Febrile Seizures in Children in the Bahteramas General Hospital, Southeast Sulawesi

Abstract. According to the Institute of Health Consensus Conference, the occurrence of febrile seizures in infants and toddlers aged 3 – 5 years old is associated with fever without any evidence of infection or intracranial causes. Children with a high body temperature of 380C (rectal temperature) are subject to febrile seizure. About 90% of febrile seizures sufferers are children under five years. In Indonesia, the prevalence of febrile is estimated to 2 – 4% while the data shown in Bahteramas Hospital during the past three years indicated an increased incidence of febrile seizures in as many as 17, 87, and 149 patients respectively in 2013, 2014, and 2015. The present study aimed to understand the relation between neonatal asphyxia and exclusive breastfeeding to the incidence of febrile seizures in children at Bahteramas Hospital, Southeast Sulawesi. This study is an analytical study with a case-control approach. The population of the study was mothers whose child suffering from febrile seizures in Mawar room from January to Mei 2016 as many as 105 patients, later 60 patients were enrolled in the study using an accidental sampling technique. The statistical analysis was made using an odds ratio and binary logistic regression. The results show that neonatal asphyxia (OR=4.750) and exclusive breastfeeding ( OR=4.929) are associated with the incidence of febrile seizures in children. It is suggested for mothers to prevent their toddlers from asphyxia and promoting a 6-month exclusive breastfeeding practice to naturally boost immunity from febrile seizure.

Serum Zinc and Magnesium Levels in Children with Febrile Seizure: A Hospital Based Cross-sectional Study

Introduction: Febrile Seizure (FS) is one of the most common forms of seizures in children. Precise aetiology of FS is still not known. Studies have shown that micronutrients like zinc, magnesium, iron, selenium, and copper are highly effective in preventing FS. Aim: To assess serum zinc and magnesium levels in children with FS and to compare them with that of febrile children without seizure, in order to find out whether serum zinc and magnesium levels have any relationship with occurrence of FS. Materials and Methods: This was a hospital based comparative cross-sectional study done in the Paediatrics department of Assam Medical College, Dibrugarh, Assam (India). One hundred and thirty children between 6-60 months, with first episode of FS, admitted in the department of paediatrics from June 2016 to May 2017 were taken as cases and 130 age and sex matched febrile children without seizure were taken as controls. After recording history, examination findings and investigations on pre-designed proforma, serum zinc and magnesium levels were estimated using colorimetric and modified methylthymol blue method respectively and comparison was made between cases and controls, and also among simple and complex FS. Data were analysed by Microsoft Excel 2010 and SPSS (Statistical Package for the Social Sciences) program version 16.0 and p&lt;0.05 was taken as significant. Results: Mean serum zinc levels in cases and controls were (79.68±21.7 μg/dL) and (120.93±29.00 μg/dL), respectively. Hypozincaemia was present in 14 (10.77%) cases and 1 (0.77%) control (p&lt;0.001). Mean serum magnesium levels in cases and controls were 2.02±0.21 mg/dL) and (2.22±0.22 mg/dL), respectively. Hypomagnesemia was present in 8 (6.15%) cases while none of the controls had hypomagnesemia (p=0.006). Mean serum zinc levels in cases with simple and complex FS were (85.55±24.13 μg/dL) and (71.92±14.97 μg/dL), respectively (p&lt;0.001). Mean serum magnesium levels in simple and complex FS were (2.11±0.21 mg/dL) and (1.90±0.14 mg/dL), respectively (p&lt;0.001). Conclusion: Children with FS had low serum zinc and magnesium levels in comparison to febrile children without seizure and both the levels were lower in children with complex FS than in simple FS.

Analysis of cytokines and trace elements in children with febrile seizures.

BackgroundFebrile seizure (FS) is a common neurological condition in children and affects 2–5% of cases of fever. FS occurs with temperature >38 °C without symptoms of central nervous system infection, severe electrolyte imbalance, or clear cause.MethodsFrom June 2018 to December 2019, 65 children with FS, and 60 children with acute upper respiratory tract infections without seizures who were admitted to the pediatric department, and 60 healthy children as the control group were selected for the study. The serum iron (SI), serum calcium (SC), interleukin (IL)-6, IL-10 and procalcitonin (PCT) levels in the two groups of children were detected. The FS group was further divided into simple FS (SFS) and complex FS (CFS).ResultsThe duration of fever in the FS group was significantly longer than in the control group (P<0.05). The SC and SI levels of the FS group were significantly lower than those in the control group (P<0.05). The SC and SI levels of the CFS group were also lower than those of the SFS group (P<0.05), and the IL-6 levels of the CFS group were significantly higher than in the SFS group (P<0.05).ConclusionsA decrease in the levels of SI, and SC and an increase of IL-6 were closely related to the occurrence of FS, suggesting that clinical attention should be paid to monitoring changes of SI, SC and IL-6 levels in children with FS. As the levels of SI and SC decrease, the frequency of possible seizures may increase. Care should be taken to correct electrolyte disorders in time.

Acute Phase Serum Leptin, Adiponectin, Interleukin-6, and Visfatin Are Altered in Chinese Children With Febrile Seizures: A Cross-Sectional Study.

Adipokines, including leptin, visfatin, adiponectin, and interleukin-6 (IL)-6, play multiple roles in the pathophysiology of epilepsy and febrile seizures (FS). We aimed to investigate the associations among plasma adipokines, mainly leptin, visfatin, adiponectin, or IL-6, and the prognosis of FS. This prospective cross-sectional study was conducted from January 2017 to December 2018 at the Wuxi Second People' Hospital China. The levels of serum leptin, visfatin, adiponectin, and IL-6 in 55 children with FS (FS group) were compared with 42 febrile children without seizure (FC group) and 48 healthy children (HC group) in an acute phase. The correlation with clinical indicators was determined by logistic regression analysis. Serum adiponectin and IL-6 levels were significantly higher in the FS group than in the FC and HC groups (p < 0.05), but there was no statistical difference between the FC and HC groups. In addition, logistic regression analysis showed that high concentrations of adiponectin and IL-6 were significantly associated with the occurrence of FS. For leptin and visfatin, they were significantly lower in the FS and FC groups than in the normal control group, but there was no statistical difference between the FS and FC groups. Our results suggest that higher plasma levels of IL-6 and adiponectin may serve as an additional biomarker in the early treatment or follow-up of the FS children.

Socio-demographic risk factors associated with febrile seizures at Puducherry: a retrospective study

Background: Febrile seizures occur commonly in the under 5 age group and is associated with few risk factors causing its recurrence like very high fever, family history of seizures, low sodium levels and younger age of onset which are subject to seasonal and wide geographical variations. This study aimed at detecting the major risk factors associated with recurrent febrile seizures in an Indian population.Methods: A retrospective hospital-based study was conducted among a total of 300 cases aged 6 months to 5 years attending to the paediatric OPD with history of fever followed by febrile seizures. Information regarding socio-demographic and clinical variables associated with febrile seizure was collected and analyzed.Results: The mean age of the study participants was 25.6±2.2 months and majority (60%) were males. Family history of seizures was present in 25.3% (n=76) of the children with febrile seizures. Respiratory infections (73.3%) and gastroenteritis (17%) were the major infective reasons associated with the occurrence of febrile seizures followed by pneumonia (6.3%) and urinary tract infections (5%). Recurrence of FS was significantly higher among the children with family history of FS (p=0.009), age at onset lesser (p&lt;0.001) and simple FS seizures.Conclusions: Younger age at onset and positive family history of seizures were important socio-demographic risk factors associated with recurrent febrile seizures.

Serum Zinc level in Children with Febrile Seizure: A Case – Control Study

Febrile seizure (FS) is the most common type of seizure in children. FS is a genetic age-limited seizure, which only occurs with febrile illness. Today, it is known that genetic factors play a major role in the occurrence of FS. Nevertheless, some trace elements, such as zinc, may play an important role in the occurrence of FS. In this study, we investigated the serum level of zinc in patients with FS and febrile children without seizure (control group). This prospective case-control study was conducted on 41 patients with simple and complex FS as the case group and 41 febrile children without seizure as the age- and sex-matched control group. The participants were admitted to Best Hospital of Hamadan, Iran between January 2013 and January 2014 . The children's age ranged from six months to five years. Serum zinc levels were measured by atomic absorption spectroscopy in these groups. The mean serum zinc levels were 70.41±20.46 and 92.73±17.62 mcg/dL in the case and control groups, respectively (P=0.001). The results showed that the serum zinc level in children with FS was significantly lower than that of the control group. Based on the present results, serum zinc level was lower in children with febrile seizure. However, further basic research is needed to examine the efficacy of zinc supplements in the prevention of FS.

Anemia With Febrile Seizure In Children Aged From Six Months Old To Five Years Old At Gotong Royong Hospital Surabaya

Introduction: Febrile seizure is one type of seizure that commonly occurs in groups of children less than five years of age, especially at the age of 2 years. The incidence of febrile seizures in children is often very worrying for parents. Aim: The purpose of the study was to examine the relationship of anemia with the occurrence of febrile seizures in children aged six months - five years old at Gotong Royong Hospital Surabaya. Methods: This study uses an Observational Study carried out with a case-control design and purposive sampling method. The study was conducted in one bone that took place between July 25 and August 25, 2017. The study was conducted by taking secondary data from medical records of children aged six months - five years who were hospitalized, consisting of 21 children with febrile seizure and 21 children with fever without a seizure, and Hb recorded in hospitalized patients. Analyze with the chi-square test. Results: Children with anemia, 8.5 times more likely to experience febrile seizures than children who did not experience anemia. Conclusion: The results showed a significant relationship between anemia and febrile seizure (p = 0.002) with an odds ratio of 8.5. Therefore, children with anemia have a higher risk of having a febrile seizure.

ASSESSMENT OF SERUM SODIUM LEVELS AMONG THE FEBRILE SEIZURES CHILDREN IN A TERTIARY CARE HOSPITAL

Background: Pathophysiology of febrile seizures (FS) remains unclear. During acute febrile illness, mild disturbances of water and electrolyte balance occur frequently, particularly hyponatremia, which might predispose the child to convulsions. Objective: The objective of the study was to assess the serum sodium levels among the children with FS in a tertiary care hospital. Materials and Methods: A prospective case–control study was conducted at a tertiary care hospital in Bengaluru from January 2014 to October 2016. A total of 80 children with febrile convulsions were taken as cases and 80 children admitted for other causes weretaken as controls. Serum sodium levels were estimated and compared. Results: Mean age of cases was 20.09±11.63 months while that of the controls was 20.08±13.1 months. Among cases, 28.7% had hyponatremia, 66.2% had normal sodium levels, and 5% had hypernatremia. In controls, hyponatremia, normal sodium levels, and hypernatremia were seen in 6.2%, 82.5%, and 11.2% children, respectively. Conclusion: Incidence of hyponatremia was significantly high among the children with FS when compared to the controls. The mean serum sodium levels in cases were significantly lower than that in controls suggesting the role of relatively lowserum sodium levels in the occurrence of FS in children.

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.

Anthropogenetic Variability in the Group of Individuals with Febrile Seizures: Population-Genetic Study.

Febrile seizures (FS) are the most common neurological disorder in childhood and are a great stress for parents due to their dramatic clinical appearance. Using test for determination of homozygously recessive characteristics in humans (HRC test) we analyzed presence, distribution, and individual combination of 20 selected genetically controlled morphophysiological traits among FS patients (N=121) and control (N=121) to determine a possible deviation in the homozygosity level and genetic loads in the group of affected children and whether there is a predisposition to the occurrence of FS. The results of our study show a statistically significant difference in the mean values of the HRC tested ( CN = 3.2 ± 0.2; FS = 4.6 ± 0.2, t= 5.74 , p< 0.0001), as well as in the distribution and variability of two studied samples (VC=55,3%, VFS= 39,6%), which indicates a complex polygenic difference among the tested groups of subjects. The differences in the degree of genetic homozygosity and variability are also present between the genders (t Cf/FSf = 4.12; t Cm/FSm = 3.98; p <0.0001) (VCf=56.9%, VFSf= 39.3%; VCm=54.1%, VFSm=40.1%). Obtained results indicate the enlargement of recessively homozygous genetic loads in the group of children with FS which may represent some kind of predisposition for expressivity of this type of seizures.