Download PDF
Journal of Pediatric Neurology 2022; 20(01): 024-027
DOI: 10.1055/s-0041-1722851
Original Article

The Association between Serum Sodium Levels and Febrile Seizures Recurrence: Is the Degree of Hyponatremia a Risk Factor?

Esma Keleş Alp 
1   Department of Pediatrics, Dr. Ali Kemal Belviranlı Obstetrics and Children's Hospital, Konya, Turkey
2   Department of Pediatric Nephrology, Dr. Ali Kemal Belviranlı Obstetrics and Children's Hospital, Konya, Turkey
,
Ahmet Midhat Elmacı 
1   Department of Pediatrics, Dr. Ali Kemal Belviranlı Obstetrics and Children's Hospital, Konya, Turkey
2   Department of Pediatric Nephrology, Dr. Ali Kemal Belviranlı Obstetrics and Children's Hospital, Konya, Turkey
› Author Affiliations Funding None.
› Further Information
Also available at
    Permissions and Reprints

Abstract

Febrile seizures are common disorders in childhood. We evaluated the serum electrolyte levels and the associated factors in children with single and recurrent febrile seizures in 24 hours period of hospitalization. The medical records of children who were clinically diagnosed with febrile seizures and hospitalized were retrospectively revealed and analyzed. Data were collected for children aged 1 to 6 years including demographic parameters and serum electrolyte levels. A total of 244 children were enrolled in the study in which 209 were diagnosed with single febrile seizures and 35 of them with recurrent febrile seizures. Serum sodium levels were significantly lower in children with recurrent febrile seizure (138.5 ± 2.38 and 134.2 ± 3.55, p < 0.001). Correlation analysis revealed that mild hyponatremia is associated with recurrence of febrile seizure within 24 hours. However, receiver-operating characteristics analysis for hyponatremia showed lower sensitivity (50.3%) and specificity (43.1%) values for optimal cutoff value of 133.5 mmol/L of serum sodium level. Our study suggested that serum sodium levels were significantly lower in children with recurrent febrile seizures. However, because of its lower sensitivity and specificity values, mild hyponatremia cannot be used as an indicator for febrile seizure recurrence.

Keywords

febrile seizure - recurrence - serum sodium levels - risk factor - children

Authors' Contributions

E.K.A. and A.M.E. designed the study and wrote the manuscript. A.M.E. collected and analyzed the data. All authors read and approved the final manuscript.


Ethical Approval

This is a retrospective study. The authors assert that all procedures contributing to this study comply with the ethical standards of the Turkish Council of Medical Research and with the Helsinki Declaration of 1975, as revised in 2008, and has been approved by the local institutional committee of Dr. Ali Kemal Belviranlı Obstetrics and Children Hospital.




Publication History

Received: 14 October 2020

Accepted: 03 December 2020

Article published online:
11 February 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Farrell K, Goldman RD. The management of febrile seizures. BCMJ 2011; 53: 268-273
    PubMedSearch in Google Scholar
  • 2 Duffner PK, Berman PH, Baumann RJ. et al. Subcommittee on Febrile Seizures; American Academy of Pediatrics. Neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics 2011; 127 (02) 389-394
    CrossrefPubMedSearch in Google Scholar
  • 3 Kiviranta T, Airaksinen EM. Low sodium levels in serum are associated with subsequent febrile seizures. Acta Paediatr 1995; 84 (12) 1372-1374
    CrossrefPubMedSearch in Google Scholar
  • 4 Hugen CA, Oudesluys-Murphy AM, Hop WC. Serum sodium levels and probability of recurrent febrile convulsions. Eur J Pediatr 1995; 154 (05) 403-405
    CrossrefPubMedSearch in Google Scholar
  • 5 Maksikharin A, Prommalikit O. Serum sodium levels do not predict recurrence of febrile seizures within 24 hours. Paediatr Int Child Health 2015; 35 (01) 44-46
    CrossrefPubMedSearch in Google Scholar
  • 6 Thoman JE, Duffner PK, Shucard JL. Do serum sodium levels predict febrile seizure recurrence within 24 hours?. Pediatr Neurol 2004; 31 (05) 342-344
    CrossrefPubMedSearch in Google Scholar
  • 7 Heydarian F, Ashrafzadeh F, Kam S. Simple febrile seizures: the role of serum sodium levels in prediction of seizure recurrence during the first 24 hours. Iran J Child Neurol 2009; 3: 31-34
    PubMedSearch in Google Scholar
  • 8 Nickavar A, Hasanpour H, Sotoudeh K. Validity of serum sodium and calcium screening in children with febrile convulsion. Acta Medica Iranica 2009; 47: 229-231
    PubMedSearch in Google Scholar
  • 9 Baek SJ, Byeon JH, Eun SH, Eun BL, Kim GH. Risk of low serum levels of ionized magnesium in children with febrile seizure. BMC Pediatr 2018; 18 (01) 297
    CrossrefPubMedSearch in Google Scholar
  • 10 Verity CM, Golding J. Risk of epilepsy after febrile convulsions: a national cohort study. BMJ 1991; 303 (6814): 1373-1376
    CrossrefPubMedSearch in Google Scholar
  • 11 Tanaka M, Natsume J, Hamano SI. et al. The effect of the guidelines for management of febrile seizures 2015 on clinical practices: nationwide survey in Japan. Brain Dev 2020; 42 (01) 28-34
    CrossrefPubMedSearch in Google Scholar
  • 12 Provisional Committee on Quality Improvement, Subcommittee on Febrile Seizures. Practice parameter: the neurodiagnostic evaluation of the child with a first simple febrile seizure. American Academy of Pediatrics. Provisional Committee on Quality Improvement, Subcommittee on Febrile Seizures. Pediatrics 1996; 97 (05) 769-772 , discussion 773–775
    PubMedSearch in Google Scholar
  • 13 Balestrino M, Somjen GG. Concentration of carbon dioxide, interstitial pH and synaptic transmission in hippocampal formation of the rat. J Physiol 1988; 396: 247-266
    CrossrefPubMedSearch in Google Scholar
  • 14 Millichap JG. Studies in febrile seizures. II. Febrile seizures and the balance of water and electrolytes. Neurology 1960; 10: 312-321
    CrossrefPubMedSearch in Google Scholar
  • 15 Chiarelli F, De Palma C, Verrotti A, Lombardi G, Domizio S. Electrolytic changes in febrile convulsions [in Italian]. Pediatr Med Chir 1985; 7 (02) 249-252
    PubMedSearch in Google Scholar
  • 16 Kiviranta T, Tuomisto L, Airaksinen EM. Osmolality and electrolytes in cerebrospinal fluid and serum of febrile children with and without seizures. Eur J Pediatr 1996; 155 (02) 120-125
    CrossrefPubMedSearch in Google Scholar
  • 17 Nadkarni J, Binaykiya I, Sharma U, Dwivedi R. Role of serum sodium levels in prediction of seizure recurrence within the same febrile illness. Neurology Asia 2011; 16: 195-197
    PubMedSearch in Google Scholar
  • 18 Halawa I, Andersson T, Tomson T. Hyponatremia and risk of seizures: a retrospective cross-sectional study. Epilepsia 2011; 52 (02) 410-413
    PubMedSearch in Google Scholar