THE PREDICTIVE VALUE OF LOW SERUM SODIUM LEVELS IN THE RECURRENCE OF SIMPLE FEBRILE CONVULSIONS

Bushra Jamahiri*, Mazen Ghalia and Ahmad Chreitah

ABSTRACT

Introduction: Febrile seizures are common in children aged 3 to 60 months, defined by the occurrence of seizures in the presence of fever (≥38°C) without central nervous system infections, lesions, trauma, or poisoning. Factors contributing to recurrence include a positive family history, age under 18 months, and low serum sodium levels. Previous studies indicate that low sodium levels significantly correlate with the recurrence of febrile convulsions. Objective: To investigate the relationship between low serum sodium levels and the recurrence of simple febrile seizures during the same febrile illness. Methods: Children presenting to the pediatric emergency department with febrile seizures underwent clinical evaluations and serum sodium assessments. Descriptive statistics summarized sample characteristics, while Chi-square and independent t-tests analyzed variable relationships. The area under the curve (AUC) method determined optimal serum sodium cutoffs for predicting seizure recurrence. Results: The study comprised 95 children (31 females, 64 males) aged 6 to 60 months (mean = 31 months). The primary causes of hyperthermia included respiratory and urinary tract infections. Recurrent febrile seizures occurred in 27.4% of cases. Median serum sodium was 138 ± 6.2 mEq/L in non-recurrent cases and 131.6 ± 3.9 mEq/L in recurrent cases. A significant difference was noted between low sodium levels and seizure recurrence, as well as between family history and recurrence. Conclusion: Hyponatremia and positive family history were significantly associated with the recurrence of febrile seizures, while age and gender do not appear to influence this outcome. A serum sodium threshold of 135 mEq/L is recommended as a predictive cutoff for seizure recurrence.

Keywords: Simple febrile seizures, Low serum sodium levels, Family history of febrile seizures.