A Comparison Between Serum Selenium Level in Febrile Children with or Without Seizure

Serum level of vitamin A in febrile children with and without seizure: A comparative study

OBJECTIVE

The role of vitamins and antioxidants in the febrile seizure (FS) has recently become of interest. The role of Vitamin A in seizure is remained controversial. It may suppress or provoke the seizure. In present study, the serum vitamin A level in febrile patients was compared with febrile seizure children for the first time.

METHOD

In a cross-sectional study, eighty children aged 6-60 months including 40 febrile children and 40 children with FS were included. Blood samples were obtained, and the serum level of vitamin A and other blood parameters were measured.

RESULTS

Patients were similar in demographic characteristics (p = 0.06 for age and p = 0.41 for sex). The serum vitamin A level was 0.19 (0.12, 0.25) and 0.22 (0.17, 0.29) milligram per liter (mg/L) in febrile and FS group respectively (p = 0.33). In children aged less than 24 months the serum vitamin A level in FS and febrile group was 0.22 ± 0.07 and 0.24 ± 0.12 mg/L respectively (p = 0.56). In children aged more than 24 months the serum vitamin A level in FS group was higher significantly in comparison with febrile group (0.25 ± 0.11 and 0.16 ± 0.07 mg/L respectively, p = 0.01).

CONCLUSION

Serum vitamin A level was not different in febrile children with and without seizure. Surprisingly in children aged more than 24 months, the serum level of vitamin A was higher in FS group than in the febrile children. More studies are needed to confirm the present observation.

Comparison of Serum Selenium, Homocysteine, Zinc, and Vitamin D Levels in Febrile Children with and without Febrile Seizures: A Prospective Single-Center Study

OBJECTIVE

Febrile seizure is a complication that makes physicians and families uneasy when detected in children with a high fevers. This study aimed to compare children with febrile seizures and children without seizures in blood selenium, zinc, homocysteine, vitamin D, vitamin B12, and magnesium levels.

MATERIALS AND METHODS

The study group included sixty-one children between the ages of 1-5 who came to the pediatric emergency department with febrile seizure. The control group had 61 children with fever without seizure, who were compatible with the study group in age, sex, and elapsed time since the onset of fever. Blood samples were taken from the patients during their admission. Selenium, zinc, vitamin D, homocysteine, vitamin B12, and magnesium levels were measured, and the data of the two groups were compared. Additionally, patients in the study group had two subgroups, simple and complex febrile seizures, and their parameters were compared.

RESULTS

Selenium, zinc, vitamin D, and vitamin B12 levels were significantly lower in the study group than in the control group (p < 0.001), and there was no significant difference in homocysteine (p = 0.990) and magnesium levels (p = 0.787) between the two groups. Moreover, no significant difference was found between those with simple and complex febrile seizures in selenium, vitamin D, homocysteine, vitamin B12, and magnesium levels.

CONCLUSIONS

Elevated levels of selenium, zinc, vitamin D, and vitamin B12 in the blood of children with fevers help to prevent febrile seizures.

The baseline risk of multiple febrile seizures in the same febrile illness: a meta-analysis

The baseline risk for multiple febrile seizures within the same febrile illness is largely unknown. Estimates range from 5 to 30%. Imprecise estimates can lead to incorrectly powering studies investigating the management of febrile seizures. To estimate the risk of multiple febrile seizures in the same febrile illness, we systematically reviewed and conducted a meta-analysis of studies from January 2000 to December 2021 that contained data for the number of children for both simple and complex febrile seizures in the same febrile illness. We searched MEDLINE, EMBASE, and Web of Science for randomized, quasi-randomized, prospective, and retrospective trials that involved children with febrile seizures. A total of 23,131 febrile illnesses with febrile seizures met the inclusion criteria. The estimated baseline risk of multiple febrile seizures in the same febrile illness was 17% (95% CI, 16-19%). However, the 30 cohorts that included both admitted and non-admitted patients had a lower percentage of multiple FSs within the same illness (14%; 95% CI, 12-15%) than the 30 cohorts that enrolled only admitted patients (20%; 95% CI, 16-25%).

CONCLUSION

Researchers can use estimates in this paper to design future studies. Taking into the account the substantial heterogeneity between countries and studies, clinicians could cautiously use our estimates in their clinical assessment and be better able to set parental expectations about a child's chances of having another febrile seizure during the current illness.

TRIAL REGISTRATION

PROSPERO CRD42020191784. Registered July 18, 2020.

WHAT IS KNOWN

• There is renewed interest in the diagnostic workup and prophylactic treatment of febrile seizures to prevent repeat seizures in the same febrile illness. • There is a lack of accurate estimates of the baseline risk for multiple febrile seizures in the same illness to properly design studies investigating management.

WHAT IS NEW

• This study provides the most robust estimates for the baseline risk for multiple febrile seizures in the same illness.