Significant Laboratory Findings in Children with Simple Febrile Seizures

Background: Simple febrile seizures (SFS) are generalized tonic clonic seizures, with a duration less than 15 minutes, no recurrence within the next 24 hours, no underlying neurological illness, no focal features during or after and presented during fever in children between 6 months and 5 years of age.

Sodium, has a well established role in the function of the neurons, by being a part of the sodium potassium ATPase complex and transitions trough voltage gated channels.

Iron deficiency anemia (IDA) is the most common nutritional deficiency in the world.Available data suggest significant association between SFS and IDA.

Objective: 78 hospitalized children with SFS in a 3 year period (2016-2018) were included. Sodium blood levels were measured in the first hour after the seizure and hemoglobin and iron values were evaluated after appropriate hydration.

Methods: Sodium and iron blood levels were measured with the assay method of Architect 4000 device and hemoglobin values with the Humacount device.

Reference ranges :sodium 136-145 mmol/L, iron 10-30 µmol/L,

Hemoglobin 95-150 g/L ( ranges by age considered)

Results:

• Sodium levels

49 children (62,8%) lower than 136 mmo/L.

20 children(25,6%) higher than 136 mmol/L.

9 children (11,5%) equal to 136 mmol/L.

• Iron levels

72 children (92,3%) lower than 10 µmol/L

6 children (7,6 %) higher than 10 µmol/L

• Hemoglobin values

39 children (50%)- age appropriate values

39 children (50%)- below range

Conclusion: There is a significant finding of a low sodium blood levels in the first hour after the SFS.We strongly recommend oral electrolyte fluids during fever in children who experienced SFS.

There is a significant result that the IDA is very common in children with SFS as preexisting condition. Consequently, iron is a better marker than hemoglobin.We strongly recommend iron+ vitamin supplementation and parental nutrition education.

Further investigations are necessary to explain the possible role of the sodium blood levels in the etiology of SFS in predisposed children.