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Jiang X, Li C, Yue Q, Wei Y, Wang Y, Lao XQ, Lin G, Chong KC. Effect of environmental exposome and influenza infection on febrile seizure in children over 22 years: a time series analysis. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024:10.1007/s00484-024-02711-8. [PMID: 38819443 DOI: 10.1007/s00484-024-02711-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 04/09/2024] [Accepted: 05/19/2024] [Indexed: 06/01/2024]
Abstract
Febrile seizures are convulsions predominately occurring in young children. The effects of various exposomes, including influenza infection and external environmental factors, on febrile seizures have not been well-studied. In this study, we elucidated the relationships between ambient temperature, air pollutants, influenza infection, and febrile seizures using 22-year territory-wide hospitalization data in Hong Kong. The aggregated data were matched with the meteorological records and air pollutant concentrations. All-type and type-specific influenza-like illness positive (ILI+) rates were used as proxies for influenza activity. Distributed lag non-linear model in conjunction with the quasi-poisson generalized additive model was used to examine the associations of interest. According to the results, all-type influenza infections were significantly associated with an increased risk of hospital admissions for febrile seizures (cumulative adjusted relative risk [ARR] = 1.59 at 95th percentile vs. 0; 95% CI, 1.51-1.68). The effect of ILI + A/H3N2 on febrile seizure was more pronounced than other type-specific ILI + rates. A low mean ambient temperature was identified as a significant risk factor for febrile seizures (cumulative ARR = 1.50 at 5th percentile vs. median; 95% CI, 1.35-1.66), while the redox-weighted oxidant capacity and sulfur dioxide were not associated with febrile seizures. In conclusion, our study underscores that influenza infections and exposure to cold conditions were related to an increased risk of febrile seizures in children. Thus, we advocate for influenza vaccination before the onset of the cold season for children to mitigate the burden of febrile seizures.
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Affiliation(s)
- Xiaoting Jiang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Prince of Wales Hospital, Shatin, New Territories, China
| | - Conglu Li
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Prince of Wales Hospital, Shatin, New Territories, China
| | - Qianying Yue
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Prince of Wales Hospital, Shatin, New Territories, China
| | - Yuchen Wei
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Prince of Wales Hospital, Shatin, New Territories, China
- Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Shenzhen, Hong Kong Special Administrative Region, China
| | - Yawen Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Prince of Wales Hospital, Shatin, New Territories, China
| | - Xiang Qian Lao
- Department of Biomedical Sciences, City University of Hong Kong, Kowloon, Hong Kong Special Administrative Region, China
| | - Guozhang Lin
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Prince of Wales Hospital, Shatin, New Territories, China
| | - Ka Chun Chong
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Prince of Wales Hospital, Shatin, New Territories, China.
- Centre for Health Systems and Policy Research, The Chinese University of Hong Kong, Shenzhen, Hong Kong Special Administrative Region, China.
- Clinical Trials and Biostatistics Laboratory, Shenzhen Research Institute, The Chinese University of Hong Kong, Shenzhen, China.
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Hassan MH, Nassar AY, Meki ARMA, Nasser SA, Bakri AH, Radwan E. Pharmacogenetic study of phosphatase and tensin homolog polymorphism (rs701848) in childhood epilepsy: relation to circulating Wnt signaling. Neurol Res 2024; 46:99-110. [PMID: 37706249 DOI: 10.1080/01616412.2023.2257465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 07/30/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE The present study aimed at evaluating the potential contribution of Phosphatase and Tensin Homolog (PTEN) and its gene polymorphism (PTEN rs701848 T/C) in relation to Wingless/integrase-1 (Wnt) signaling in childhood epilepsy and the impact of antiepileptic medications on their serum levels. METHODS This study included 100 children with epilepsy (50 pharmacoresistant and 50 pharmacoresponsive) and 50 matched controls. All subjects had their genotypes for the PTEN rs701848T/C polymorphism assessed using TaqManTM assays and real-time PCR. By using the sandwich ELISA technique, the blood concentrations of PTEN and Wnt3a were measured. RESULTS Serum Wnt3a levels in epileptic patients were significantly higher than in the control group, p < 0.001. Children with epilepsy who received oxcarbazepine had considerably lower serum Wnt3a levels than those who didn't, p < 0.001.With an AUC of 0.71, the cutoff value for diagnosing epilepsy as serum Wnt3a > 6.2 ng/mL has a sensitivity of 55% and a specificity of 80%. When compared to controls, epileptic children had considerably more (TT) genotype and less (TC and CC) genotypes, p < 0.05 for all. Epileptic children had significantly higher (T) allele frequency than controls, p = 0.006 with OR (95%CI) = 1.962(1.206-3.192). Pharmacoresistant epileptic children had significantly higher (TT) genotype compared to pharmacoresponsive type (p = 0.020). CONCLUSION We originally found a strong association between PTEN rs701848 T/C and childhood epilepsy, in particular pharmacoresistant type. Serum Wnt3a levels increased in epilepsy, but were not significantly different between different alleles of PTEN. In pharmaco-responsive children Wnt3a levels differed significantly between the different PTEN genotypes. Antiepileptics may affect Wnt3a levels.
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Affiliation(s)
- Mohammed H Hassan
- Department of Medical Biochemistry, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Ahmed Y Nassar
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Abdel-Raheim M A Meki
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt
- Department of Biochemistry, Sphinx University, New Assiut city, Assiut, Egypt
| | - Shimaa A Nasser
- Department of Biochemistry, Faculty of Pharmacy, South Valley University, Qena, Egypt
| | - Ali Helmi Bakri
- Department of Pediatrics, Faculty of Medicine, South Valley University, Qena, Egypt
| | - Eman Radwan
- Department of Medical Biochemistry, Faculty of Medicine, Assiut University, Assiut, Egypt
- Department of Biochemistry, Sphinx University, New Assiut city, Assiut, Egypt
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Cheng A, Xiong Q, Wang J, Wang R, Shen L, Zhang G, Huang Y. Development and validation of a predictive model for febrile seizures. Sci Rep 2023; 13:18779. [PMID: 37907555 PMCID: PMC10618474 DOI: 10.1038/s41598-023-45911-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 10/25/2023] [Indexed: 11/02/2023] Open
Abstract
Febrile seizures (FS) are the most prevalent type of seizures in children. Existing predictive models for FS exhibit limited predictive ability. To build a better-performing predictive model, a retrospective analysis study was conducted on febrile children who visited the Children's Hospital of Shanghai from July 2020 to March 2021. These children were divided into training set (n = 1453), internal validation set (n = 623) and external validation set (n = 778). The variables included demographic data and complete blood counts (CBCs). The least absolute shrinkage and selection operator (LASSO) method was used to select the predictors of FS. Multivariate logistic regression analysis was used to develop a predictive model. The coefficients derived from the multivariate logistic regression were used to construct a nomogram that predicts the probability of FS. The calibration plot, area under the receiver operating characteristic curve (AUC), and decision curve analysis (DCA) were used to evaluate model performance. Results showed that the AUC of the predictive model in the training set was 0.884 (95% CI 0.861 to 0.908, p < 0.001) and C-statistic of the nomogram was 0.884. The AUC of internal validation set was 0.883 (95% CI 0.844 to 0.922, p < 0.001), and the AUC of external validation set was 0.858 (95% CI 0.820 to 0.896, p < 0.001). In conclusion, the FS predictive model constructed based on CBCs in this study exhibits good predictive ability and has clinical application value.
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Affiliation(s)
- Anna Cheng
- Department of Emergency, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qin Xiong
- Department of Emergency, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Jing Wang
- Department of Emergency, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Renjian Wang
- Department of Emergency, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lei Shen
- Department of Emergency, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Guoqin Zhang
- Department of Emergency, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yujuan Huang
- Department of Emergency, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Remonde CG, Gonzales EL, Adil KJ, Jeon SJ, Shin CY. Augmented impulsive behavior in febrile seizure-induced mice. Toxicol Res 2023; 39:37-51. [PMID: 36726823 PMCID: PMC9839938 DOI: 10.1007/s43188-022-00145-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/04/2022] [Accepted: 07/01/2022] [Indexed: 02/04/2023] Open
Abstract
Febrile seizure (FS) is one of the most prevalent etiological events in childhood affecting 2-5% of children from 3 months to 5 years old. Debates on whether neurodevelopmental consequences rise in later life following a febrile seizure or not are still ongoing however there is limited evidence of its effect, especially in a laboratory setting. Moreover, the comparative study using both male and female animal models is sparse. To examine the effect of FS on the behavioral features of mice, both sexes of ICR mice were induced with hyperthermic seizures through exposure to an infrared heat lamp. The mice were divided into two groups, one receiving a single febrile seizure at postnatal day 11 (P11) and one receiving three FS at P11, P13, and P15. Starting at P30 the FS-induced mice were subjected to a series of behavioral tests. Mice with seizures showed no locomotor and motor coordination deficits, repetitive, and depressive-like behavior. However, the FS-induced mice showed impulsive-like behavior in both elevated plus maze and cliff avoidance tests, which is more prominent in male mice. A greater number of mice displayed impaired CAT in both males and females in the three-time FS-induced group compared to the single induction group. These results demonstrate that after induction of FS, male mice have a higher susceptibility to consequences of febrile seizure than female mice and recurrent febrile seizure has a higher chance of subsequent disorders associated with decreased anxiety and increased impulsivity. We confirmed the dysregulated expression of impulsivity-related genes such as 5-HT1A and tryptophan hydroxylase 2 from the prefrontal cortices of FS-induced mice implying that the 5-HT system would be one of the mechanisms underlying the increased impulsivity after FS. Taken together, these findings are useful in unveiling future discoveries about the effect of childhood febrile seizure and the mechanism behind it.
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Affiliation(s)
- Chilly Gay Remonde
- School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul, 05029 Republic of Korea
| | - Edson Luck Gonzales
- School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul, 05029 Republic of Korea
| | - Keremkleroo Jym Adil
- School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul, 05029 Republic of Korea
| | - Se Jin Jeon
- School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul, 05029 Republic of Korea
| | - Chan Young Shin
- School of Medicine and Center for Neuroscience Research, Konkuk University, Seoul, 05029 Republic of Korea
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Sharawat IK, Panda PK, Kumar V, Ramachandran A, Bhardwaj S, Murugan VK, Pradhan AK, Rajendiran R, Bhat NK. Effectiveness of prophylactic iron supplementation in the reduction of recurrence of febrile seizures in children: A prospective study with comparison with historical controls. J Neurosci Rural Pract 2022; 13:718-724. [PMID: 36743742 PMCID: PMC9893947 DOI: 10.25259/jnrp-2022-7-19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Accepted: 09/20/2022] [Indexed: 11/19/2022] Open
Abstract
Objectives The primary objective of the study was to compare the number of patients with febrile seizure recurrence within 1 year of presenting to our institute, among patients who received and didn't receive oral iron supplementation. Materials and Methods This prospective intervention study with historical controls was conducted to compare the number of patients with febrile seizure recurrence within 1 year, among patients who received and did not receive oral iron supplementation. The intervention group additionally received prophylactic iron supplementation of 20 mg biweekly for 1 year. Results A total of 53 patients each were enrolled in both the groups, with comparable baseline characteristics. Although there was a trend toward a lower rate of recurrence of febrile seizures in the interventional group, as compared to the control group, it did not reach the point of statistical significance (P = 0.35). Both in the worst-case scenario and best-case scenario, there was a trend toward less risk of recurrence of febrile seizure in the intervention group, but it did not reach the point of statistical significance (P = 0.43 and 0.52). For the original scenario, worst-case scenario, and best-case scenario, the absolute risk reduction was 6.5%, 7%, and 6%, respectively, with corresponding number needed to treat (NNT) being 15, 14, and 16, respectively. The trend for absolute risk reduction was more pronounced in those with complex febrile seizures with an NNT of 6.5, but it still did not reach the point of statistical significance (P = 0.16). Moderate/severe IDA was also found to be an independent risk factor for recurrence of febrile seizure in the intervention group (P = 0.03). Conclusion Oral serum iron supplementation does not significantly reduce the recurrence rate of febrile seizures in children aged 6-60 months. However, there is a trend toward reduction in the frequency of recurrence of febrile seizures, which is more pronounced in the subset with complex febrile seizures.
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Affiliation(s)
- Indar Kumar Sharawat
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Prateek Kumar Panda
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Vinod Kumar
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Aparna Ramachandran
- Department of Neurology, IQRAA International Hospital and Research Centre, Kozhikode, Kerala, India
| | - Sanjot Bhardwaj
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | | | - Amit Kumar Pradhan
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rajkali Rajendiran
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Nowneet Kumar Bhat
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Panda PK, Sharawat IK. Effect of Tepid Sponging Versus Warm Sponging on Body Temperature and Comfort among Under-Five Children with Pyrexia: Correspondence. Indian J Pediatr 2022; 89:837. [PMID: 35171437 DOI: 10.1007/s12098-022-04101-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 01/18/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Prateek Kumar Panda
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, India
| | - Indar Kumar Sharawat
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, India.
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Miyagi Y, Sasano T, Kato H, Kin K. Hyponatremia and Recurrent Febrile Seizures During Febrile Episodes: A Meta-Analysis. Cureus 2022; 14:e24398. [PMID: 35619851 PMCID: PMC9126426 DOI: 10.7759/cureus.24398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2022] [Indexed: 12/02/2022] Open
Abstract
Several studies have investigated the potential effects of hyponatremia on recurrent febrile seizures (RFS) during febrile illness. Because findings were inconsistent across studies, we aimed to evaluate the serum sodium levels in febrile seizures (FS) of children with or without RFS during the same episode. We conducted electronic searches in three databases (PubMed, EMBASE, Cochrane Library) and one scholarly search engine (Google Scholar) up to June 2021 for studies on FS. Screening was done based on the titles and abstracts of primary studies. Then, eligibility was reviewed based on the abstracts. Finally, in order to match the inclusion and exclusion criteria, full-text articles were evaluated by two authors and inconsistencies were discussed. Data extraction was carried out by two independent authors. The extracted variables were author's name, article title, journal name, year of publication, study location, study design, sample size, and mean and standard deviation of blood Na concentration in FS. We performed a risk of bias assessment of included studies using the Newcastle-Ottawa Scale (NOS). The effect size was calculated using the standardized mean difference (SMD), and random-effects models were used for the analysis. A total of 12 articles were included with a single outlier. This analysis suggested that serum sodium level was lower in patients with RFS during the same febrile episode than in those with single FS, with SMD of -0.70, (n=1784; 95% CI: -1.03, -0.36; Z=-4.10, p<0.01; I2 86.67%, p<0.01). In the sensitivity analysis, no significant change was observed in pooled SMD. The optimal cutoff value of serum sodium level was 134.72 mmol/L with an area under the receiver operating characteristic curve of 0.81 (95% CI: 0.61, 1.00), with sensitivity of 80.0% and specificity of 70.0%. This result indicated a significant association between hyponatremia and RFS during the same febrile episode. Decreased serum sodium levels may be involved in seizure recurrence and may play a role in FS pathogenesis.
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Mauro A, Di Mari C, Casini F, Giani T, Sandini M, Biondi L, Calcaterra V, Zuccotti GV, Bernardo L. Neurological manifestations of Kawasaki disease and multisystem inflammatory syndrome in children associated with COVID-19: A comparison of two different clinical entities. Front Pediatr 2022; 10:1088773. [PMID: 36683824 PMCID: PMC9849814 DOI: 10.3389/fped.2022.1088773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/02/2022] [Indexed: 01/07/2023] Open
Abstract
Kawasaki disease (KD) is one of the most frequent idiopathic vasculitis in children, affecting medium- and small-sized vessels. Multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 has recently emerged as a new systemic hyperinflammatory condition affecting children some weeks after an acute COVID-19 infection. KD and MIS-C share different aspects and differ in many others: patients affected by MIS-C are usually older, with prominent gastrointestinal manifestations, diffuse adenopathy, extensive conjunctivitis, myocardial damage, leukopenia, and thrombocytopenia at the laboratory exams. Both conditions can present neurological complications. The aim of this manuscript is to provide a narrative review of neurological involvement in KD and MIS-C. A comprehensive review literature has been performed, and the main clinical features have been analyzed, contributing to neurological differential diagnosis.
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Affiliation(s)
- A Mauro
- Pediatric Rheumatology Unit, Department of Childhood and Developmental Medicine, Fatebenefratelli-Sacco Hospital, Milan, Italy
| | - C Di Mari
- Pediatric Rheumatology Unit, Department of Childhood and Developmental Medicine, Fatebenefratelli-Sacco Hospital, Milan, Italy
| | - F Casini
- Pediatric Department, "Vittore Buzzi" Children's Hospital, Milan, Italy
| | - T Giani
- Department of Pediatrics, Anna Meyer Children's Hospital, Florence, Italy
| | - M Sandini
- Pediatric Rheumatology Unit, Department of Childhood and Developmental Medicine, Fatebenefratelli-Sacco Hospital, Milan, Italy
| | - L Biondi
- Pediatric Rheumatology Unit, Department of Childhood and Developmental Medicine, Fatebenefratelli-Sacco Hospital, Milan, Italy
| | - V Calcaterra
- Pediatric Department, "Vittore Buzzi" Children's Hospital, Milan, Italy.,Department of Pediatrics, Anna Meyer Children's Hospital, Florence, Italy.,Department of Internal Medicine, University of Pavia, Pavia, Italy
| | - G V Zuccotti
- Pediatric Department, "Vittore Buzzi" Children's Hospital, Milan, Italy
| | - L Bernardo
- Pediatric Rheumatology Unit, Department of Childhood and Developmental Medicine, Fatebenefratelli-Sacco Hospital, Milan, Italy
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Shajari H, Shajari A, Azizkhan H, Barzegari R. Correlation of Serum Ferritin and Calcium Level with Febrile Seizures: A Hospital-Based Prospective Case-Control Study. MAEDICA 2021; 16:420-425. [PMID: 34925597 PMCID: PMC8643545 DOI: 10.26574/maedica.2021.16.3.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Background:Febrile seizure is one of the most common seizure disorders occurring in children. In the literature, there are contradicting results about the role of iron and calcium deficiency in febrile seizures that has a relatively higher prevalence. So, this study was performed to investigate the correlation of serum ferritin and calcium levels with febrile seizures in children. Materials and methods:This case-control study was performed on a total number of 150 children aged 6 to 60 months who were frequently admitted to Shohada-e-Kargar Hospital in Yazd, Iran, due to fever from April 2017 to November 2017. The case group consisted of 49 patients with febrile seizures and the control group included 101 febrile children without seizures. Data regarding age, sex, past medical and family history of seizures, serum ferritin, and calcium levels were collected from patient medical records and laboratory results. Results:Participants in the case and control groups had a mean age of 28.22 months and 28.16 months, respectively. Of all participants, 56% were males. Serum ferritin level was 40.61 ng/mL in the case group and 41.80 ng/mL in the control group, with no significant difference being observed between groups (P value = 0.743). Calcium levels were 9.50 mmol/L in the case group and 9.59 mmol/L in the control group, with no significant difference being observed between groups (P value = 0.564). The findings of the present research indicated that factors including age, sex, past medical and family history of seizures did not affect the mean serum levels of ferritin and calcium of the study population. Conclusions:Based on our results, no significant difference could be established between serum ferritin and calcium levels in neither the case group nor the control group, and plausibly, these elements appear to be neither a protective nor a risk factor for a febrile seizure.
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Affiliation(s)
- Hamideh Shajari
- Department of Neonatology, Shariati Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Shajari
- Department of Pediatrics Nephrology, Ali-ebne-Abitaleb School of Medicine, Islamic Azad University, Yazd branch, Yazd, Iran
| | - Hamideh Azizkhan
- Department of Pediatrics Nephrology, Ali-ebne-Abitaleb School of Medicine, Islamic Azad University, Yazd branch, Yazd, Iran
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Christensen KJ, Dreier JW, Skotte L, Feenstra B, Grove J, Børglum A, Mitrovic M, Cotsapas C, Christensen J. Birth characteristics and risk of febrile seizures. Acta Neurol Scand 2021; 144:51-57. [PMID: 33822360 DOI: 10.1111/ane.13420] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/06/2021] [Accepted: 03/09/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE Febrile seizure is a common childhood disorder that affects 2-5% of all children, and is associated with later development of epilepsy and psychiatric disorders. This study determines how the incidence of febrile seizures correlates with birth characteristics, age, sex and brain development. METHODS This is a cohort study of all children born Denmark between 1977 and 2011 who were alive at 3 months of age (N = 2,103,232). The Danish National Patient Register was used to identify children with febrile seizures up to 5 years of age. Follow-up ended on 31 December 2016 when all cohort members had potentially reached 5 years of age. RESULTS In total, 75,593 (3.59%, 95% CI: 3.57-3.62%) were diagnosed with febrile seizures. Incidence peaked at 16.7 months of age (median: 16.7 months, interquartile range: 12.5-24.0). The 5-year cumulative incidence of febrile seizures increased with decreasing birth weight (<1500 g; 5.42% (95% CI: 4.98-5.88% vs. 3,000-4,000 g; 3.53% (95% CI: 3.50-3.56%)) and with decreasing gestational age at birth (31-32 weeks; 5.90% (95% CI: 5.40-6.44%) vs. 39-40 weeks; 3.56% (95% CI: 3.53-3.60)). Lower gestational age at birth was associated with higher age at onset of a first febrile seizure; an association that essentially disappeared when correcting for age from conception. CONCLUSIONS The risk of febrile seizures increased with decreasing birth weight and gestational age at birth. The association between low gestational age at birth and age at first febrile seizure suggests that onset of febrile seizures is associated with the stage of brain development.
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Affiliation(s)
- Kirstine J. Christensen
- Department of Economics and Business Economics National Centre for Register‐Based Research Aarhus BSS Aarhus University Aarhus Denmark
- Department of Neurology Aarhus University Hospital Aarhus Denmark
| | - Julie W. Dreier
- Department of Economics and Business Economics National Centre for Register‐Based Research Aarhus BSS Aarhus University Aarhus Denmark
| | - Line Skotte
- Department of Epidemiology Research Statens Serum Institut Copenhagen Denmark
| | - Bjarke Feenstra
- Department of Epidemiology Research Statens Serum Institut Copenhagen Denmark
| | - Jakob Grove
- Department of Biomedicine Aarhus University Aarhus Denmark
| | - Anders Børglum
- Department of Biomedicine Aarhus University Aarhus Denmark
| | - Mitja Mitrovic
- Department of Neurology Yale School of Medicine New Haven CT USA
| | - Chris Cotsapas
- Department of Neurology Yale School of Medicine New Haven CT USA
| | - Jakob Christensen
- Department of Economics and Business Economics National Centre for Register‐Based Research Aarhus BSS Aarhus University Aarhus Denmark
- Department of Neurology Aarhus University Hospital Aarhus Denmark
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Panda PK, Sharawat IK, Sharma V, Sherwani P. Leigh Syndrome and SURF1 Gene Presenting with Febrile Seizure. Ann Indian Acad Neurol 2020; 24:251-252. [PMID: 34220073 PMCID: PMC8232513 DOI: 10.4103/aian.aian_567_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/08/2020] [Accepted: 08/21/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Prateek Kumar Panda
- Department of Pediatrics, Pediatric Neurology Division, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Indar Kumar Sharawat
- Department of Pediatrics, Pediatric Neurology Division, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Vishakha Sharma
- Department of Pediatrics, Pediatric Neurology Division, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Poonam Sherwani
- Department of Radiodiagnosis and Imaging, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Sharawat I, Panda P. Relationship between serum sodium levels and febrile seizure recurrence in children. J Pediatr Neurosci 2020; 15:345-346. [PMID: 33531969 PMCID: PMC7847092 DOI: 10.4103/jpn.jpn_103_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/21/2020] [Accepted: 05/21/2020] [Indexed: 11/05/2022] Open
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Mekonnen FH, Lakew WD, Tesfaye ZD, Swain PK. Statistical models for longitudinal zero-inflated count data: application to seizure attacks. Afr Health Sci 2019; 19:2555-2564. [PMID: 32127828 PMCID: PMC7040296 DOI: 10.4314/ahs.v19i3.31] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Background Chronic non-communicable diseases:- such as epilepsy, are increasingly recognized as public health problems in developing and African countries. This study aimed at finding determinants of the number of epileptic seizure attacks using different count data modeling techniques. Methods Four common fixed-effects Poisson family models were reviewed to analyze the count data with a high proportion of zeros in longitudinal outcome, i.e., the number of seizure attacks in epilepsy patients. This is because, in addition to the problem of extra zeros, the correlation between measurements upon the same patient at different occasions needs to be taken into consideration. Results The investigation remarkably identified some important factors associated with epileptic seizure attacks. As people grow old, the number of seizure attacks increased and male patients had more seizures than their female counterparts. In general, a patient's age, sex, monthly income, family history of epilepsy andservice satisfaction were some of the significant factors responsible for the frequency of seizure attacks (P value<0.05). Conclusion This study suggests that zero-inflated negative binomial is the best model for predicting and describing the number of seizure attacks as well as identifying the potential risk factors. Addressing these risk factors will definitely contain the progression of seizure attack.
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Affiliation(s)
- Fenta Haile Mekonnen
- Department of Statistics, College of Science, Bahir Dar University, Bahir Dar- Ethiopia
| | - Workie Demeke Lakew
- Department of Statistics, College of Science, Bahir Dar University, Bahir Dar- Ethiopia
| | - Zike Dereje Tesfaye
- Department of Statistics, College of Science, Bahir Dar University, Bahir Dar- Ethiopia
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Management of Pediatric Febrile Seizures. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102232. [PMID: 30321985 PMCID: PMC6210946 DOI: 10.3390/ijerph15102232] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Revised: 10/08/2018] [Accepted: 10/09/2018] [Indexed: 01/21/2023]
Abstract
Febrile seizures (FS), events associated with a fever in the absence of an intracranial infection, hypoglycaemia, or an acute electrolyte imbalance, occur in children between six months and six years of age. FS are the most common type of convulsions in children. FS can be extremely frightening for parents, even if they are generally harmless for children, making it important to address parental anxiety in the most sensitive manner. The aim of this review was to focus on the management of FS in the pediatric age. An analysis of the literature showed that most children with FS have an excellent prognosis, and few develop long-term health problems. The diagnosis of FS is clinical, and it is important to exclude intracranial infections, in particular after a complex FS. Management consists of symptom control and treating the cause of the fever. Parents and caregivers are often distressed and frightened after a FS occurs and need to be appropriately informed and guided on the management of their child’s fever by healthcare professionals. Due to the inappropriate use of diagnostic tests and treatments, it is extremely important to improve the knowledge of pediatricians and neurologists on FS management and to standardize the diagnostic and therapeutic work-up.
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Evaluation of Viral (HHV6, Adenovirus, HSV1, Enterovirus) and Bacterial Infection in Children with Febrile Convulsion by Serum PCR and Blood Culture Mofid Children’s Hospital , 2016 - 2017. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2018. [DOI: 10.5812/pedinfect.63954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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16
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Leung AK, Hon KL, Leung TN. Febrile seizures: an overview. Drugs Context 2018; 7:212536. [PMID: 30038660 PMCID: PMC6052913 DOI: 10.7573/dic.212536] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 06/16/2018] [Accepted: 06/19/2018] [Indexed: 12/14/2022] Open
Abstract
Background Febrile seizures are the most common neurologic disorder in childhood. Physicians should be familiar with the proper evaluation and management of this common condition. Objective To provide an update on the current understanding, evaluation, and management of febrile seizures. Methods A PubMed search was completed in Clinical Queries using the key terms ‘febrile convulsions’ and ‘febrile seizures’. The search strategy included meta-analyses, randomized controlled trials, clinical trials, observational studies, and reviews. Results Febrile seizures, with a peak incidence between 12 and 18 months of age, likely result from a vulnerability of the developing central nervous system to the effects of fever, in combination with an underlying genetic predisposition and environmental factors. The majority of febrile seizures occur within 24 hours of the onset of the fever. Febrile seizures can be simple or complex. Clinical judgment based on variable presentations must direct the diagnostic studies which are usually not necessary in the majority of cases. A lumbar puncture should be considered in children younger than 12 months of age or with suspected meningitis. Children with complex febrile seizures are at risk of subsequent epilepsy. Approximately 30–40% of children with a febrile seizure will have a recurrence during early childhood. The prognosis is favorable as the condition is usually benign and self-limiting. Intervention to stop the seizure often is unnecessary. Conclusion Continuous preventative antiepileptic therapy for the prevention of recurrent febrile seizures is not recommended. The use of intermittent anticonvulsant therapy is not routinely indicated. Antipyretics have no role in the prevention of febrile seizures.
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Affiliation(s)
- Alexander Kc Leung
- Department of Pediatrics, The University of Calgary, Alberta Children's Hospital, Calgary, Alberta, Canada
| | - Kam Lun Hon
- Department of Pediatrics, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Theresa Nh Leung
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
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Gontko-Romanowska K, Żaba Z, Panieński P, Steinborn B, Szemień M, Łukasik-Głębocka M, Ratajczak K, Górny J. The assessment of laboratory parameters in children with fever and febrile seizures. Brain Behav 2017; 7:e00720. [PMID: 28729928 PMCID: PMC5516596 DOI: 10.1002/brb3.720] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Revised: 03/27/2017] [Accepted: 03/30/2017] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The aim of the research paper was to assess selected laboratory results in children with fever without seizures and febrile seizure. MATERIALS AND METHODS The paper presents an analysis of a group of 306 children aged 6 months - 5 years who were admitted with diagnosed fever without seizures and febrile seizures in Specialized Health Care Centre for Mother and Child in Poznan between 1st January 2008 and 31st December 2009. Out of the diagnostics procedures performed in children the following ones were taken into consideration: BCC and CRP. RESULTS Of the analyzed group of 306 children, 59.48% were boys and 40.52% were girls. In the studied group 61.93% were boys and control group 56.15% were boys. Mean age of admitted children was 22 months. In the study group mean body temperature was 39.0°C and in the control group 38.6°C. A statistically significant difference was found between body temperature of study and control group (p = .005). The mean C-reactive protein level in the study group was 15.73 mg/L and in the control group 58.20 mg/L. There was a statistically significant difference (p < .001). There was a statistically significant difference between the number of lymphocytes and neutrophils (p < .001). There was also a statistically significant difference between the number of hemoglobin, hematocrit and platelets. CONCLUSIONS The study showed that children with FS, had statistically significant higher neutrophils level compared to those with fever without seizures. The number of lymphocytes was lower in children with FS than in children with fever without seizures.
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Affiliation(s)
- Krystyna Gontko-Romanowska
- Department of Emergency Medicine Poznan University of Medical Sciences Poznan Poland.,Specialized Health Care Centre for Mother and Child Poznan Poland
| | - Zbigniew Żaba
- Department of Teaching Anesthesiology and Intensive Therapy Poznan University of Medical Sciences Poznan Poland
| | - Paweł Panieński
- Department of Emergency Medicine Poznan University of Medical Sciences Poznan Poland.,Specialized Health Care Centre for Mother and Child Poznan Poland
| | - Barbara Steinborn
- Department of Developmental Neurology Poznan University of Medical Sciences Poznan Poland
| | - Michał Szemień
- Department of Emergency Medicine Poznan University of Medical Sciences Poznan Poland
| | | | - Krystian Ratajczak
- Department of Emergency Medicine Poznan University of Medical Sciences Poznan Poland
| | - Jacek Górny
- Department of Emergency Medicine Poznan University of Medical Sciences Poznan Poland
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Tang JW, Holmes CW, Elsanousi FA, Patel A, Adam F, Speight R, Shenoy S, Bronnert D, Stiefel G, Sundaram P, Pande S, Sridhar A, Kairamkonda V, Bandi S. Cluster of human parechovirus infections as the predominant cause of sepsis in neonates and infants, Leicester, United Kingdom, 8 May to 2 August 2016. ACTA ACUST UNITED AC 2017; 21:30326. [PMID: 27589339 PMCID: PMC5144936 DOI: 10.2807/1560-7917.es.2016.21.34.30326] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 08/25/2016] [Indexed: 11/29/2022]
Abstract
We report an unusually high number of cases (n = 26) of parechovirus infections in the cerebrospinal fluid (CSF) of neonates and infants admitted with sepsis in the United Kingdom during 8 May to 2 August 2016. Although such infections in neonates and infants are well-documented, parechovirus has not been routinely included in many in-house and commercial PCR assays for CSF testing. Clinicians should consider routine parechovirus testing in young children presenting with sepsis.
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Affiliation(s)
- Julian W Tang
- Clinical Microbiology and Virology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
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Mandal A, Sahi PK. Correspondence: Evaluation of Risk Factors Associated with First Episode of Febrile Seizure. J Clin Diagn Res 2017; 11:SL01. [PMID: 28274017 DOI: 10.7860/jcdr/2017/21510.9123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Accepted: 06/28/2016] [Indexed: 11/24/2022]
Affiliation(s)
- Anirban Mandal
- Attending Consultant, Department of Paediatrics, Sitaram Bhartia Institute of Science and Research , New Delhi, India
| | - Puneet Kaur Sahi
- Senior Resident, Department of Paediatrics, Kalawati Saran Children's Hospital , New Delhi, India
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