Serum Glucose and Electrolyte Levels in Children with and without Febrile Seizures: A case-control study (preprint)

ABSTRACT

Background: Febrile seizures (FS) occur in children aged six to sixty months with a febrile illness not associated with a central nervous system infection or metabolic disorder. Risk factors include; age, history of the disease, certain vaccinations, or iron and zinc deficiencies. Studies show significant hyponatremia, hypocalcemia, and hyperkalemia in children with febrile seizures. Similarly, cerebrospinal fluid hyperglycemia is common in febrile convulsions. This study aimed to retrospectively assess the relationship between febrile seizures, and electrolyte & glucose imbalance among children with fever, and also compare the annual trends of febrile seizure-related admissions pre- and post-Covid 19 pandemics. Methods:  A case-control study was conducted from January 2018 to January 2022 at Zhongnan Hospital of Wuhan University, Hubei, China. 876 children aged 6 to 60 months were divided into 438 cases with febrile seizures (cases) and 438 with fever but without seizures (controls). Serum glucose and electrolyte levels at the time of hospitalization as well as age, gender, birth weight, gestational age, temperature, and causes of fever, in both groups were retrieved, analyzed, and compared. Results: Febrile seizure admissions among children aged 6-60 months were significantly reduced to less than 23.4% during the Covid-19 pandemic. Children with febrile seizures had significantly higher serum glucose levels than those with fever but without seizures (p < 0.05). The serum sodium levels of children with seizures were significantly lower than those without seizures (p < 0.05). Sodium levels were significantly lower among children with complex seizures (p < 0.05). There was no significant difference in the serum electrolyte levels of potassium and calcium between the cases and controls (p > 0.05). A significant positive correlation was found between serum sodium levels and the occurrence of febrile seizures (r = [0.156]; p < 0.05). Conclusion: The study found that admission rates for febrile seizures decreased during Covid-19 and lower sodium levels could be a risk factor for the occurrence of febrile seizures.