Comparison of Serum Zinc Levels Measured by Inductively Coupled Plasma Mass Spectrometry in Preschool Children with Febrile and Afebrile Seizures

BACKGROUND: Changes in levels of trace elements have been proposed to underlie febrile seizures. Particularly, low zinc levels have been proposed as related factor of febrile seizure. In this study, we investigated whether mean serum zinc levels differed between children with febrile seizure and afebrile seizure. METHODS: Using inductively coupled plasma mass spectrometry, serum zinc levels were measured in 288 children who had been diagnosed with febrile seizures (N=248) and afebrile seizures (N=40). Mean serum zinc levels were compared between the 2 groups. RESULTS: Mean serum zinc level was 60.5+/-12.7 microg/dL in the febrile seizure group and 68.9 +/-14.5 microg/dL in the afebrile seizure group. A significant difference in serum zinc levels was observed between the febrile and afebrile seizure groups (P<0.001). CONCLUSIONS: Zinc levels in children with febrile seizure were significantly lower than those in children with afebrile seizure.

Serum zinc level in children with febrile convulsion and its comparison with that of control group

Febrile convulsion is the most common disorder in childhood with good prognosis. There are different hypotheses about neurotransmitters and trace element [such as zinc] changes in cerebrospinal fluid and serum, which can have a role in pathogenesis of febrile convulsion. The aim of the present prospective analytical case-control study was to determine whether there was any changes in serum zinc level in children with febrile convulsion during seizure. Ninety-two children aged 6 months to 5 years were divided into three groups: group A, 34 children with febrile convulsion, group B, 40 children having fever without convulsion, and group C, and 18 children with non-febrile convulsion. Serum zinc levels for the three groups were estimated by atomic absorption spectrophotometry [AAS]. Data were analyzed to compare zinc level among the three groups using appropriate statistical tools employing SPSS 13. Serum zinc levels of groups A, B, and C had a mean value of 76.82 +/- 24.36mg/1, 90.12 +/- 14.63 mg/1 and 94.53 +/- 17.39 mg/l, respectively. Serum zinc level of group A was lower than those of the other two groups [P < 0.006]. It was also lower in group B than in group C [P < 0.006]. These findings revealed that serum zinc level decreases during infection; this decrease was more significant in patients with febrile convulsion

Serum diazepam levels after oral administration in children.

OBJECTIVE: To determine serum levels of diazepam after oral administration in children. PATIENTS AND METHOD: Forty six children admitted with febrile seizures were orally administered with 0.25 mg/kg/dose of diazepam six hourly for four doses. Trough (prior to the next dose) and peak (at 1 hour 20 minutes after the dose) serum levels of diazepam were analyzed. The patients were observed for adverse effects of the medication. RESULTS: The peak levels after 1st, 2nd, 3rd and 4th doses were above 0.15 microg/ml which is considered the therapeutic level in 93.5, 97.8, 97.7, and 100 per cent of the patients, respectively. The trough levels prior to the 2nd, 3nd, and 4th doses were greater than 0.15 microg/ml in 75.0, 84.0, and 91.3 per cent, respectively. Neither recurrent seizure nor serious adverse effects occurred in any of the patients. CONCLUSION: Serum concentrations above the therapeutic level were achieved after orally administered diazepam at 0.25 mg/kg/dose six hourly for four doses. Oral diazepam may be used as another method in the prevention of recurrent febrile seizures.

Cytokines and zinc levels in serum and cerebrospinal fluid of children with febrile seizures and encephalitis

The present study was proposed in an attempt to understand the role of serum and cerebrospinal fluid [CSF] levels of proinflammatory cytokines [TNF-alpha, IL-1beta and IL-6] and zinc in children with febrile convulsions and cases with encephalitis in comparison with normal ranges. Fifty patients were enrolled in the study, 15 with febrile convulsions, 15 patients with acute encephalitis and a control group of 20 patients with febrile illness but no convulsions. Serum and CSF levels of TNF-alpha, IL1-Beta and IL-6 were significantly higher in cases with encephalitis than in cases with febrile convulsions and control. There were no significant differences between cases with febrile convulsions and controls. On comparing cases with febrile convulsions and cases with encephalitis, serum and CSF levels of pro-inflammatory cytokines were significantly higher in cases with encephalitis. It was also found that children with febrile convulsions had decreased serum and CSF levels of zinc much less than in both cases with encephalitis and control groups. The correlation between serum and CSF levels of pro-inflammatory cytokines was significantly positive for cases with febrile convulsions and encephalitis, while there was no correlation between serum and CSF zinc levels in both groups

Alterations of cell-mediated immune response in children with febrile seizures

The aim of the present investigation was to study the distribution of T-cell subsets in peripheral blood defined monoclonal antibodies and by the lymphocyte proliferative response to phytohemagglutinin (PHA) in 30 children febrile seizures and in 14 age-matched control subjects. Frequent respiratory, urinary and dermatologic infections were observed in 22 patients. The immunologic parameters showed that 64 percent of the patients presented an increases number of CD8+ cells and a low helper/suppressor ratio was observed in 60 percent of the patients. In addition, the proliferative response of lymphocytes to PHA was impared in the patients. It was observed the presence of inhibitory activity on lymphocyte function in the plasma of 33 percent of children with febrile seizures. These results suggest that patients with febrile seizures have an impairment of cellular immunity that may be connected with this epileptic syndrome and explain the infections observed.

Serum prolactin and cortisol in children with some paroxysmal disorders.

Postictal serum prolactin and cortisol levels were estimated in 73 children having either epilepsy, febrile seizures, breath-holding spells, or fever without other manifestation and in 20 normal controls. Mean serum prolactin levels (28.6 +/- 2.3 ng/ml) were significantly higher (p < 0.001) in the epileptic group than in the group with febrile seizures (12.7 +/- 2.8 ng/ml), non-specific febrile illness (12.2 +/- 2.4 ng/ml), breath-holding spells (8.8 +/- 1.1 ng/ml) and normal controls (9.8 +/- 2.6 ng/ml). Mean serum cortisol levels were non-specifically elevated in children with epilepsy (32.8 +/- 2.2 ug/dl), febrile convulsion (34.2 +/- 4.1 ug/dl) and non-specific febril illness (30.6 +/- 2.4 ug/dl). Our observations suggest that elevated prolactin levels associated with afebrile epileptic seizures may help in differentiating epilepsy from febrile seizures and breath-holding spells. Cortisol levels appear to be non-specifically elevated in all stressful conditions.