Zinc Status in Febrile Seizure: A Case-Control Study

How to Cite This Article: Salehiomran MR, Mahzari M. Zinc Status in Febrile Seizure: A Case-Control Study. Iran J Child Neurol. 2013 Autumn; 7(4):20-23.ObjectiveFebrile seizure is the most common type of seizure in children. Their incidence is 2-5%. There are different hypotheses about relationship between neurotransmitters and trace elements (such as zinc) and febrile seizure. Zinc, asa major element of some enzymes, plays an important role in the central nervous system (CNS) and can affect some inhibitory mechanisms of CNS. The aim of the present study was to determine whether there were any changes in serumzinc level in children with febrile seizure in comparison with febrile children without seizure.Materials & MethodsThis case-control study was performed on 100 patients aged 6 months to 6 years.This study was conducted between January and August 2012, on 50 children with febrile seizures (case) and 50 febrile children without seizures (control), that were referred to Amirkola Children Hospital (a referral hospital in the northof Iran). Two groups were matched for age and sex. The serum zinc levels in the both groups were determined by atomic absorption spectrophotometry method.ResultsThe mean serum zinc level was 0.585±0.166 mg/L and 0.704±0.179 mg/L in the case group and the control group, respectively (p=0.001). The mean serum zinc level was significantly lower in the febrile seizure group compared to thecontrol groups.  ConclusionOur findings revealed that serum zinc level was significantly lower in children with simple febrile seizure in comparison with febrile children without seizure. It can emphasize the hypothesis that there is a relation between serum zinc level and febrile seizure in children. ReferencesVarma RR. Febrile seizures. Indian J Pediatr 2002; 69(8); 697-700.Talebian A, Vakili Z, Talar SA, Kazemi M, Mousavi GA. Assessment of the relation between serum zinc and magnesium levels in children with febrile convulsion. Iranian j pathol 2009;4(4):157-60.Mollah MA, DEy PR, Tarafdar SA, Akhter S, Ahmed S, Hassan T, et al. Zinc in CSF of patients with febrile convulsion. Indian J Pediatr 2002;69(10):859-61.Auvichayapat P, Auvichayapat N, Jedsrisuparp A, Thinkhamrop B, Sriroj S, Piyakulmala T, et al. Incidence of febrile seizures in thalassemic patients. J Med Assoc Thai 2004;87(8):970-3.Nelson KB, Ellenberg JH. Prenatal and perinatal antecedents of febrile seizures. Ann Neurol 1990;27(2):127-31.Udani V.Pediatric epilepsy - An Indian perspective. Indian J Pediatr 2005; 72(4):309-13.Ehsanipour F, Talebi-Taher M, Harandi N, Kani k. Serum zinc level in children with febrile convulsion and its comparison with that of control group. Iranian J Pediatr 2009;199:65-8.Heydarian F, Ashrafzadeh F, Kam S. Simple febrile seizure: The role of serum sodium levels in prediction of seizure recurrence during the first 24 hours. Iran J Child Neurol 2009;3(2):31-4.Jun-Hwa Lee, Jeong Hyun Kim. Comparison of Serum Zinc Levels Measured by Inductively Coupled Plasma Mass Spectrometry in Preschool Children with Febrile and Afebrile Seizures. Ann Lab Med 2012;32(3):190-3.Heydarian F, Ashrafzadeh F, Ghasemian A. Serum zinc level in patient with simple febrile seizure. Iran J Child Neurol 2010;4(2):41-3.Garty B, Olomucki R, Lerman ST, Nitzan M. Cerebrospinal fluid zinc concentration in febrile convulsion. Arch Dis Child 1995;73(4):338-41.Daoud AS, Batieha A, Abu-Ekteish F, Gharaibeh N, Ajlouni S, HijaziS. Iron status: a possible risk factor for the first febrile seizure. Epilepsia 2002;43(7):740-3.Ganesh R, Janakiraman L, Meenakshi B. Serum zinc levels are low in children with simple febrile seizures compared with those in children with epileptic seizures and controls. Ann Trop Paediatr 2011;31(4):345-9.Cho WJ, Son BH, Kim SW. Levels of Sodium and Zinc concentration in febrile convulsion. Korean Child Neural Soc1999;7(2):214-9.Burtis carl A, Ashwood, Edwhard R; Brun, David E. Tietz fundamentals of clinical chemistry. 6th ed. Philadelphia: Saunders Elsevier; 2008. P. 505-7.Smart TG, Hosie AM, Miller PS. Zn2+ ions: modulators of excitatory and inhibitory synaptic activity. Neuroscientist 2004;10(5):432-4.Mollah MA, Rakshit SC, Anwer KS, Arslan MI, saha N, Ahmeds, et al. Zinc concentration in serum and cerebrospinal fluid simultaneously decrease in children with febrile seizure: Finding from a Prospective study in Bangladesh. Acta pediatr 2008;97(12):1707-11.  

Neonatal seizure and short-term outcomes in hospitalized neonates

Background: Neonatal seizure is a common problem and associated with a great mortality rate, high risk of chronic neurodevelopmental impairments, also difficult to diagnosis and treatment. The aim of this study was to determine the neurodevelopmental outcome, clinical presentation and etiology of seizures in neonates admitted to Amirkola Children's Hospital (ACH). Methods: In this cross-sectional study, 42 neonates with the initial diagnosis of seizure, aged less than 28 days, hospitalized in ACH, northern Iran, from April to September 2016 were selected using convenient sampling method. The patients' information was gathered during hospitalization period and 6 months after discharge. Data were analyzed using SPSS 22 through descriptive and chi-square tests. Results: Among preterm and term neonates with seizures, the main diagnosis in neonates with seizures was idiopathic (38.1%) and hypoxic-ischemic encephalopathy (HIE) (14.3%), hypoglycemia (9.5 %) hypomagnesaemia (7.1%) and opiate withdrawal (4.8%). Twenty-three neonates underwent brain computed tomography (CT) scan and 6 (14.3%) of them had abnormal brain imaging. Seizure control with antiepileptics (P=0.006), metabolic disturbance (P=0.002) and time of drug discontinuation (P<0.001) were significantly associated with adverse neurodevelopmental outcome. Conclusions: Since idiopathic encephalopathy and HIE were the most common cause of neonatal seizures, it should be attempted to improve care during delivery

The serum sodium levels and recurrence of simple febrile seizure during the first 24 hours in children

Background: Febrile seizure (FS) is one of the most common neurologic disorders in children. Electrolyte imbalance especially hyponatremia may have an important role in triggering the febrile seizure. The measure of serum electrolytes will be useful in predicting the further seizure. The aim of this study was to investigate the effect of relative hyponatremia (RH) on the risk of recurrent febrile seizures. Methods: This prospective study was performed on 334 children (6-60-month) with convulsions, referred to Amirkola children's Hospital. The patients were divided into three groups: simple febrile seizure (SFS), complex febrile seizure (CFS) and seizure without fever. In each group, the serum sodium was measured at the beginning of the admission and followed for 24 hours, and electrolyte imbalance was evaluated in seizure recurrences. Data were analyzed using SPSS-16 (student's t-test and logistic regression). Results: Of the 334 children, 105 (31.7%) and 229 (68.3%) patients were female and male, respectively. The mean serum sodium levels in patients with SFS, CFS and control group were 136.64, 134.91 and 137.38 meq/l, respectively (p<0.05), but potassium and calcium levels were in the normal range. CFS group had a significant RH in comparison to SFS group (p<0.05). Conclusions: The serum sodium level was significantly lower in simple and complex seizures compared to the control group. Measurements of serum sodium levels and hyponatremia diagnosis have a key role on predicting the FS occurrence and recurrence. Therefore, physicians should be careful to administer the serums and inject the solutions for children with fever

Neonatal seizure and short-term outcomes in hospitalized neonates

Background: Neonatal seizure is a common problem and associated with a great mortality rate, high risk of chronic neurodevelopmental impairments, also difficult to diagnosis and treatment. The aim of this study was to determine the neurodevelopmental outcome, clinical presentation and etiology of seizures in neonates admitted to Amirkola Children's Hospital (ACH). Methods: In this cross-sectional study, 42 neonates with the initial diagnosis of seizure, aged less than 28 days, hospitalized in ACH, northern Iran, from April to September 2016 were selected using convenient sampling method. The patients' information was gathered during hospitalization period and 6 months after discharge. Data were analyzed using SPSS 22 through descriptive and chi-square tests. Results: Among preterm and term neonates with seizures, the main diagnosis in neonates with seizures was idiopathic (38.1) and hypoxic-ischemic encephalopathy (HIE) (14.3), hypoglycemia (9.5 ) hypomagnesaemia (7.1) and opiate withdrawal (4.8). Twenty-three neonates underwent brain computed tomography (CT) scan and 6 (14.3) of them had abnormal brain imaging. Seizure control with antiepileptics (P=0.006), metabolic disturbance (P=0.002) and time of drug discontinuation (P&#60;0.001) were significantly associated with adverse neurodevelopmental outcome. Conclusions: Since idiopathic encephalopathy and HIE were the most common cause of neonatal seizures, it should be attempted to improve care during delivery

Treatment of large cutaneous facial hemangioma with ropranolol in a child with biliary atresia and esophageal varices

Introduction: Biliary atresia (BA) is the most common cause of neonatal jaundice, for which surgery is indicated. It may lead to portal hypertension and esophageal varices. Sometimes, BA is related to other congenital anomalies and malformation, while a coexistence of BA with facial hemangioma has not been reported, yet. Infantile hemangioma is a childhood benign vascular tumor. Beta blocker has an effect on hemangioma and esophageal varices. Case Report: A 30-day-old girl with an infantile hemangioma was referred to Amirkola Children's Hospital. According to intraoperative cholangiography and liver biopsy information, BA was diagnosed. Also, she had a large infantile cutaneous hemangioma on her face. Portal hypertension and esophageal varices were diagnosed in her under observation. So, propranolol was prescribed for her. A year after that, her facial hemangioma was gradually getting better. Conclusions: association of BA with infantile cutaneous hemangioma is rare and cutaneous hemangioma can be treated by propranolol

Evaluation of the developmental outcome in children with congenital hypothyroidism

Background: Congenital hypothyroidism (CH) is one of the most common endocrine diseases and one of the major causes of mental retardation in children. So we aimed to evaluate the developmental outcome of children with CH. Methods: This case-control study was performed on two 3-6-year-old groups of 100 patients. The case group was children with CH, referred to Endocrine Clinic of Amirkola Childrenchr('39')s Hospital (2011-2017) and the control group was healthy children and normal from other states. The Denver developmental screening test-II (DDSTII) was used to assess the developmental factors and disorders in four areas of gross motor, fine motor, personal-social and language. Data were analyzed by SPSS 21 using descriptive statistics, t-test and chi-square, and a p&#60;0.05 was considered significant. Results: The mean age of 200 children in the case and control groups was 54.62&#177;15.72 and 59.68&#177;15.64 months, respectively. In the case group, 45 and 55 of them had transient and permanent CH, respectively. All four criteria of DDSTII in the control group as well as gross motor in the case group were normal, but fine motor, personal-social and language were reported normal in 94, 95 and 93 of the case group, respectively. All subjects with abnormal DDSTII, had a negative neonatal screening tests. Conclusion: The results obtained from DDSTII indicated that 6 of children with CH had an abnormal development, all who had an onset of medical treatment over 30 days, which makes it important to screen the neonatal thyroid disease and diagnose this disease timely

Evaluation of Vitamin D Level in Children With Febrile Seizure Referred to Amirkola Children’s Hospital, Babol

Objective. This study aim to evaluate the level of vitamin D with the incidence of febrile seizure. Method. This case-control study was conducted on 90 febrile children referred to Amirkola Children’s Hospital from 19 February to 21 August 2021. Febrile children with and without seizures were considered as case and control groups, respectively. Vitamin D, calcium, phosphorus, and alkaline phosphatase were evaluated. Results. The mean level of vitamin D was not significant between the 2 groups ( P  = .62), but the mean level of alkaline phosphatase was higher in the case group, statistically ( P  = .04). 46.75% and 15.6% of case group, 28.9% and 26.7% of control group had deficiency and insufficiency levels of vitamin D, respectively ( P  = .17). Conclusion. In this study the mean level and deficiency of Vitamin D were not significant between the 2 groups. No correlation was also found between Vitamin D levels and the incidence of Febrile Seizure

COVID-19 and renal involvement in children: a retrospective study

Background: The New coronavirus (SARS COV-2) can cause acute respiratory disease and also multiorgan dysfunction. There is insufficient data about kidney involvement in children. So, this study was done on children with COVID-19 to evaluate nephrological involvement. Methods: All children with confirmed or suspected COVID-19 who were admitted in Children Hospital .were enrolled. They were admitted in hospital from March 2020 to July 2020. Serum Blood Urea Nitrogen (BUN), creatinine, sodium, potassium, calcium and urinalysis were evaluated. Also, glomerular filtration rate (GFR) was calculated by Schertz&#39;s formula. All patients were evaluated by chest x-ray and/or computerized tomography scanning (CTS). The data were analyzed by SPSS software and P value less than 0.05 was determined as significant. Results: Forty-seven children with confirmed or suspected COVID-19 were enrolled to this study. At admission, 23.4 and 27.7 of children with COVID-19 had abnormal increase in serum BUN and creatinine, respectively. Also 78.8 and 25.5 of children had GFR less than 90 and 60 ml/min /1.732, respectively. Additionally, 13/47 (27.7) of children had abnormal urine analysis (microscopic hematuria and/or proteinuria). There wasn&#8217;t a significant relationship between pulmonary lesions and abnormal reduction of GFR (P&#60;0/05). Conclusion: In the study, the risk of AKI (acute kidney injury) and decrease of GFR and also abnormal urinalysis is high in children with COVID-19. So, more attention for detection of kidney involvement is necessary and more conservative management for prevention of AKI and decrease of GFR are recommended