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Objective:To investigate the association between serum zinc levels and convulsive brain injury in infants with mild gastroenteritis complicated with benign infantile seizures (BICE) and febrile seizures (FC).Methods:A case-control study method was conducted. 120 children with mild gastroenteritis and convulsion admitted to the First Affiliated Hospital of Hebei North University from January 2020 to January 2022 were enrolled as the research subjects. They were divided into BICE group and FC group according to the type of convulsion. The serum zinc level, the frequency and duration of convulsion, and the occurrence of convulsive brain injury in the two groups were recorded. Multivariate Logistic regression analysis was used to screen the risk factors for convulsive brain injury. The Spearman correlation method was used to analyze the association between serum zinc levels, clinical characteristics of convulsion and convulsive brain injury.Results:A total of 120 children were enrolled, of which 81 developed to BICE and 39 developed to FC during hospitalization. The serum zinc level of children in the FC group was significantly lower than that in the BICE group (μmol/L: 39.24±6.50 vs. 48.65±7.21, P < 0.01). In the BICE group and FC group, the serum zinc level in children with more than 2 convulsions was significantly lower than that in the children with one convulsion (μmol/L: 37.65±6.50 vs. 53.17±7.55 in the BICE group, and 30.27±5.58 vs. 44.16±7.57 in the FC group, both P < 0.01). Serum zinc level in children with convulsion duration ≥5 minutes was significantly lower than that in the children with convulsion duration < 5 minutes (μmol/L: 38.75±6.74 vs. 51.21±7.58 in the BICE group, and 31.08±5.46 vs. 45.19±7.25 in the FC group, both P < 0.01). Moreover, the serum zinc level of children with different convulsion frequency and duration in the FC group was significantly lower than that in the BICE group (all P < 0.01). Among the 120 children, 9 cases of convulsive brain injury occurred, and the incidence rate was 7.50%. The incidence of convulsive brain injury in the BICE group was 1.23% (1/81), which was significantly lower than 20.51% in the FC group (8/39, P < 0.01). The serum zinc level of children with convulsive brain injury was significantly lower than that of children with non-brain injury (μmol/L: 28.50±5.00 vs. 60.22±7.31, P < 0.01), and the number of convulsion was significantly higher than that of non-cerebral injury (≥ 2 convulsions: 100.00% vs. 1.80%, P < 0.01), and the duration of convulsion in children with brain injury was significantly longer than that of non-brain-injured children (convulsion duration ≥5 minutes: 100.00% vs. 11.71%, P < 0.01). Multivariate Logistic regression analysis showed that decreased serum zinc level [odds ratio ( OR) = 2.147, 95% confidence interval (95% CI) was 1.354-3.403], increased number of convulsion ( OR = 3.452, 95% CI was 1.266-9.417), and prolonged convulsion duration ( OR = 3.117, 95% CI was 1.326-7.327) were independent risk factor for convulsive brain injury in children with mild gastroenteritis and convulsion (all P < 0.05). Spearman correlation analysis showed that serum zinc level, convulsion ≥2 times, duration of convulsion ≥5 minutes and convulsion ≥2 times + convulsion duration ≥5 minutes were significantly negatively correlated with the occurrence of convulsive brain injury in FC children ( r values were -0.546, -0.517, -0.522, and -0.528, all P < 0.01). There was no significant correlation between serum zinc level, convulsion ≥2 times, convulsion duration ≥5 minutes and convulsion ≥2 times+convulsion duration ≥5 minutes and convulsive brain injury in BICE children ( r values were -0.281, -0.129, -0.201, -0.243, all P > 0.05). Conclusions:Serum zinc level is related to the characteristics of convulsive symptoms in children with mild gastroenteritis complicated with FC, and has a strong negative correlation with the occurrence of convulsive brain injury. Active targeted intervention and treatment may help reduce the incidence of brain injury in children.
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Background: A febrile convulsion is linked with high temperature but without significant underlying health issues. These occur most often in children aged six months to five years. Most of the convulsions last less than five minutes, and within an hour of the occurrence, the child is entirely back to normal.Methods: Sixty children aged 3 months to 5 years admitted to the emergency pediatric ward with a history of convulsion fever with convulsions, in Narayana Medical College and Hospital were taken up for the study with clinical history, clinical examination, laboratory Investigations.Results: Among 60 children in the study group, 15 (25%) of them were aged between 3 months to 12 months, 21 (35%) of them were between 13 months to 24 months. Gender 36 (60%) are male children. 24 (40%) are female children. Family history of convulsions was positive in 18 (30%) of the 60 (100%) cases, and 7 had family history of epilepsy. 42 (70%) are negative. Most of the cases (85%) showed no growth in blood culture.Conclusions: Blood culture should be performed in all children by febrile convulsions, especially those under the stage of two years. Streptococcus pneumonia was the organism isolated from respiratory tract infection in a child with febrile convulsion with significant bacteremia. The symptoms that present can be as harmless as rhinorrhea or cough. Children with a positive family history of afebrile convulsion should be closely monitored and test, as they can develop epilepsy later.
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Introduction: Seizure is a common problem evaluated inpediatric emergency department. The different causes ofseizures are febrile seizures, CNS infections, metabolic,developmental defects, traumatic brain injury, vascularaccidents, brain tumors and idiopathic or epilepsy. Currentresearch aimed to study the etiology of convulsions in childrenbetween 1 month to 5 years of age admitted in pediatricward, Government General Hospital, Guntur. To assess thecommon incidence of convulsions in children of age 1 to 5years admitted to pediatric ward, Department of Pediatrics,Government General Hospital, Guntur.Material and methods: Our study was retrospective,descriptive study. 100 cases admitted to pediatric ward,Government General Hospital, Guntur with convulsions in theage group of 1 month to 5 years during the period of July 2018and April 2019. Study was done by detailed history, throughphysical examination and relevant investigations includingcomplete blood counts, serum electrolytes, serum glucose,serum calcium, CSF analysis, EEG and neuroimaging (CT/MRI brain) studies. Variables recorded were demographics,clinical presentation, laboratory investigations, EEG andneuroimaging.Results: The most common cause of seizures in our study wasfebrile seizures (32%). About 24% cases were due to epilepsy(idiopathic or unprovoked) and 33% cases were symptomaticseizures of various causes like CNS infection, metabolic,traumatic, vascular etc.Remaining 11% were due to othermiscellaneous causes.Conclusion: This was the hospital based retrospective,descriptive study to know the etiology of convulsions inchildren between 1 month to 5 years. Convulsions in childrencan be due to various underlying pathology. In our study mostcommon cause of convulsions was febrile seizures, followedby epilepsy and symptomatic seizures of infective etiology ofCNS, viral encephalitis being the most common.
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Background: Febrile seizure (FS) is the most common type of childhood seizure disorder with a prevalence of 2-5% in children less than 5 years. Although the prognosis of febrile seizure is usually good, however, the possibility of recurrence keeps many parents and families in a state of anxiety and concerned, for years after the first seizure. Thus, intermittent prophylactic treatment might be advised in children with high risk of recurrence.Methods: The study was a prospective randomized, double blind, placebo-controlled trial conducted at Department of Pediatrics, Umaid Hospital, Dr S N Medical College, Jodhpur on neurologically normal children aged from 6 months to 5 years with a history of simple febrile seizures and normal electroencephalogram without any evidence of acute central nervous system infection. Subjects were randomly prescribed oral clobazam according to weight of child and placebo when they developed a febrile disease during the first 48 h of the onset of fever.' Temperature reduction measures with paracetamol and tepid sponging were also advised. Patients were followed up for the frequency and time of febrile seizure recurrence, febrile episodes and side effects of drugs for 12 months.Results: Ten (3.8%) of 257 episodes in clobazam group and 38 (14.07%) episodes in placebo group had seizure recurrence (p value <0.001). The two groups were not significantly different in terms of side effects. (p >0.05).Conclusions: Intermittent oral clobazam therapy is a very effective measure in preventing recurrence of febrile seizures.
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Objective To explore the electroencephalogram (EEG)features and related factors of children with febrile convulsion (FC).Methods The clinical and EEG data of 168 FC children were retrospectively analyzed.Results Of 168 children with FC,the initial issuance of 147 patients aged 0.5 -3 years old (87.30%),>3 years was 21 cases (11.10%),3 -year -old children within the age of multiple febrile seizures;the abnormal rate of EEG≤3 years old febrile seizures was 25.20%,>3 years old abnormal rate was 75.00%,indicated that with age increased,higher rate of EEG abnormalities;abnormal rate of EEG in children ≥ 38.5℃ was 26.20%,EEG abnormal rate in children 3 times the EEG abnormality was 64.88%(P <0.05),indicated that repeated seizures,the likelihood of cerebral injury larger. Conclusion EEG abnormality rate is related with clinical features of the FC;FC EEG in children should be regular inspections to closely follow up observation of disease prognosis.
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Background: Febrile convulsions continue to be a common occurrence in paediatric practice in Nigeria and Africa. Constant review of the subject from time to time is therefore desirable. Methods: We prospectively studied over a seven month period the prevalence, aetiology and outcome of febrile convulsions among children admitted into the children emergency room (CHER) of the Wesley Guild Hospital (WGH), Ilesa, South West Nigeria. Results: Over the study period, febrile convulsions accounted for 18.0% of all the 880 admissions into the CHER. The children were aged 3 months to 6years with male: Female ratio of 1.1:1. Malaria was the commonest identified aetiology associated with febrile convulsions in this study. It occurred in 80.4% of the 158 children with febrile convulsions, followed by respiratory tract infections. Outcome was good as none of the patients developed neurologic deficit or died. Conclusion: Febrile convulsions are common among children admitted at the CHER of the WGH, Ilesa with malaria being the major aetiology. Adequate malaria control may reduce the burden associated with febrile convulsions in this environment.
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PURPOSE: Febrile convulsions are classified into simple or complex types, the latter being characterized by increased risk of recurrence and progression to epilepsy. This study aimed to delineate the clinical characteristics of complex febrile convulsions. METHODS: Between January 2003 and December 2006, 550 children were diagnosed with febrile convulsions at the Department of Pediatrics, Ilsan Paik Hospital. Their medical records were retrospectively reviewed for comparison between simple and complex febrile convulsions, and clinical findings of complex febrile convulsions were clarified. RESULTS: Our subjects comprised a male-to-female ratio of 1.64:1; the age range was from 8 months to 8 years. Simple febrile convulsions comprised 432 cases, i.e., 4 times as many as complex febrile convulsions (118 cases). The causes of febrile illness included acute pharyngotonsillitis (357 cases, 64.9%), pneumonia (55 cases, 10.0%), acute gastroenteritis (37 cases, 6.7%), and otitis media (20 cases, 3.6%). We did not find any significant difference between simple and complex febrile convulsions in most clinical parameters such as gender, age, family history of febrile convulsions, and cause of febrile illness. Regarding subtypes of complex febrile convulsions, repeated convulsions were the most frequent (72.0%), followed by prolonged convulsions (16.9%) and focal convulsions (5.1%). CONCLUSION: We have reported here the clinical features of complex febrile convulsions. Although the results did not show any significant difference between simple and complex febrile convulsions in most clinical parameters such as gender, age, family history of febrile convulsion, and cause of febrile illness, further studies are essential to delineate complex febrile convulsions.
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Niño , Humanos , Epilepsia , Gastroenteritis , Registros Médicos , Otitis Media , Pediatría , Neumonía , Recurrencia , Estudios Retrospectivos , Convulsiones , Convulsiones FebrilesRESUMEN
PURPOSE: Fever plays an important role in causing disturbances in the fluid and electrolyte balance, especially in an immature brain. Recently, it was reported that hyponatremia enhanced the susceptibility of febrile convulsions in children and increased the risk of repeat convulsions during the same febrile illness. We studied the relationship between hyponatremia and febrile convulsions. METHODS: Blood samples for electrolyte measurements were taken from 52 children who visited Chosun University Hospital between June 1997 and July 1998(patient group I: simple febrile convulsion, patient group II: repeated febrile convulsions). We checked serum electrolytes in groups of age-matched controls(control group I: no fever, no convulsion, control group II: fever only, control group III: non-febrile convulsion). The results were analyzed by Student's t-test and ANOVA test. RESULTS: The mean serum sodium level of both patient groups(136.8+/-2.3mmol/L) was significantly lower when compared to all control groups(control groupI: 140.7+/-2.5mmol/L, control group II: 139.7+/-3.1mmol/L, control group III: 139.7+/-4.6mmol/L)(P0.05). The mean serum sodium level in the group with repeat convulsions(136.8+/-2.4mmol/L) was not significantly lower than the mean in the group with simple febrile convulsions(136.7+/-2.2mmol/L). There was no statistical relationship between the level of serum sodium and the probability of repeat convulsions(r=0.19, P>0.05). CONCLUSION: Our results show that low serum sodium concentration may increase the risk of febrile convulsions. However, there is no statistical relationship between the level of serum sodium and the probability of repeat convulsions. These findings warrant further studies on the relationship between the control of electrolyte levels and seizures.