Assessment of Hypokalemia and Certain Risk Factors for Febrile Seizure among Children Aged 6 Months to 6 Years in Mashhad, Iran

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Pediatrics, School of Medicine, Islamic Azad University, Tehran Medical Sciences Branch, Tehran, Iran

2 General Practitioner, Islamic Azad University, Mashhad Branch, Mashhad, Iran

Abstract

Background: Febrile seizures (FS) are the most common seizure disorders which occur in 2% - 4% of children aged 6 months to 6 years old. We aimed to determine risk factors for the FC including hypokalemia in Iranian children.Methods: This case-control study was performed on 212 children from 6 months to 6 years old in Mashhad, who were admitted to the hospital from 2010 to 2011. 110 patients with FC were considered as case group and 102 children with fever without seizure were as control group. Variables including age, gender, degree of fever, duration and cause of fever, breastfeeding and its duration, birth weight, body mass index, gestational age, child's head circumference, serum potassium levels, and anemia were compared in two groups.Findings: There were significant differences between two groups regarding different variables. In case group, febrile seizure was significantly more common in mail children, more featured in respiratory tract infection and otitis media and occurred in the early period of fever .History of FC, mean birth weight, and mean head circumference were significantly higher and serum level of potassium was significantly lower than those of control group.Conclusion: This study showed that in addition to the known risk factors, hypokalemia plays an important role in occurrence of febrile seizure as a new risk factor. Further studies are recommended to investigate this issue and other unknown risk factors to prevent febrile seizure.

Keywords


  1. Sadleir LG, Scheffer IE. Febrile seizures. BMJ 2007; 334(7588): 307-11.
  2. Marcdante K, Kliegman RM, Behrman RE. Nelson essentials of pediatrics. 6th ed. Philadelphia,PA: Saunders; 2010.p. 681.
  3. Mikati AM. Febrile seizures. In: Kliegman RM, Stanton BMD, Geme JS, Schor NF, Behrman RE, editors. Nelson textbook of pediatrics. 19th ed. Philadelphia, PA: Saunders; 2011. p. 2017-8.
  4. Abd EF, El GH. Risk factors of febrile seizures among preschool children in Alexandria. J Egypt Public Health Assoc 2002; 77(1-2): 159-72.
  5. Graves RC, Oehler K, Tingle LE. Febrile seizures: risks, evaluation, and prognosis. Am Fam Physician 2012; 85(2): 149-53.
  6. Roddy MS, Swift JD, Newton DA, Anas NG. Seizures. In: Perkin RM, editor. Pediatric hospital medicine: textbook of inpatient management. 2nd ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2007. p.266.
  7. Baumann RJ, Kao A, Riviello Jr JJ, Talavera F, Mack KJ, Benbadis RS. Pediatric febrile seizures [Online]. [cited 2012]; Available from: URL: http://emedicine.medscape.com/article/1176205-overview
  8. American Academy of Pediatrics. Febrile seizures: clinical practice guideline for the long-term management of the child with simple febrile seizures. Pediatrics 2008; 121(6): 1281-6.
  9. Garfunkel CL, Kaczorowski M.J, Christy C. Pediatric clinical advisor: instant diagnosis and treatment. 2nd ed. Philadelphia, PA: Mosby, Elsevier; 2007. p. 203-4.
  10. Schuchmann S, Hauck S, Henning S, Gruters-
  11. Kieslich A, Vanhatalo S, Schmitz D, et al. Respiratory alkalosis in children with febrile seizures. Epilepsia 2011; 52(11): 1949-55.
  12. Naveed uR, Billoo AG. Association between iron deficiency anemia and febrile seizures. J Coll Physicians Surg Pak 2005; 15(6): 338-40.
  13. Mahyar A, Ayazi P, Fallahi M, Javadi A. Risk factors of the first febrile seizures in Iranian children. Int J Pediatr 2010; 2010: 862897.
  14. Valman B, Thomas R. ABC of the first year. 6th ed. London, UK: Wiley-Blackwell; 2009. p. 109-12.
  15. Waruiru C, Appleton R. Febrile seizures: an update. Arch Dis Child 2004; 89(8): 751-6.
  16. Huff EA. Breastfeeding prevents seizures, study finds [Online]. [cited 2011 Feb 12]; Available from: URL:http://www.naturalnews.com/031307_breastfeeding_seizures.html.
  17. Farivar Kh, Tayarani Bathayi A. Protective effects of breast milk on central nervous system and the incidence of febrile convulsion in breast-fed children. Iran J Pediatr 1999; 9(1): 49-55. [In Persian].
  18. Helbig I, Lawrence KM, Connellan MM, Torn-Broers Y, Vadlamudi L, Eckhaus J, et al. Obstetric events as a risk factor for febrile seizures: a community-based twin study. Twin Res Hum Genet 2008; 11(6): 634-40.
  19. Fallah R, Karbasi SA. Recurrence of febrile seizure in Yazd, Iran. Turk J Pediatr 2010; 52(6): 618-22.
  20. Daoud AS, Batieha A, Abu-Ekteish F, Gharaibeh N, Ajlouni S, Hijazi S. Iron status: a possible risk factor for the first febrile seizure. Epilepsia 2002; 43(7): 740-3.
  21. Hartfield DS, Tan J, Yager JY, Rosychuk RJ, Spady D, Haines C, et al. The association between iron deficiency and febrile seizures in childhood. Clin Pediatr (Phila) 2009; 48(4): 420-6.
  22. Bidabadi E, Mashouf M. Association between iron deficiency anemia and first febrile convulsion: A case-control study. Seizure 2009; 18(5): 347-51.
  23. Shlomo S. Febrile seizures. In: Swainan KF, Ashwal S, Ferriero DM, Schor NF, editors. Pediatric neurology principles and practice. Philadelphia, PA: Mosby; 2006. p. 1081–6.