Profile of Febrile Seizures in Children and Association with Serum Sodium Levels in a Tertiary Centre in Sokoto, Nigeria

Abstract

Background: Febrile seizures (FS) are a major presentation in young children with febrile illnesses. They may occur recurrently within the same febrile illness. This study sought to examine the profile of children with febrile convulsions and association of hyponatremia with recurrent febrile seizures. Methodology: The study determined the clinical characteristics, recurrence pattern and serum sodium level of children with FS admitted into the Department of Paediatrics of Usmanu Danfodiyo University Teaching Hospital (UDUTH), Sokoto, Nigeria. It was a retrospective study from January 2019 to December 2020. Cases were children aged 3 months to 6 years admitted with FS. Their case folders were extracted and relevant data entered into a proforma sheet and data was analyzed using SPSS version 23. Results: 357 of 4583 (7.8%) admitted children had FS, 230 were male (64.4%) with M:F ratio of 1.8:1. Their age ranged from 3 to 72 months with mean of 33.6 (±17.3) months. 201 (56.3%) had simple FS while 156 (43.7%) had complex FS. Higher proportion of females had complex FS though not significant (Ꭓ2=0.61; p=0.73). The commonest documented cause of fever was malaria (70.3%). 177 (49.6%) had recurrent episodes FS on admission. Of the total, 118 had serum sodium results retrieved, 60 (50.8%) had hyponatremia with mean level of 129.3mmol/l (±5.5); this was slightly lower in those with recurrent seizures within the illness but not significant. It was also lower in those with complex seizures especially those with higher temperatures on admission. There were 6 mortalities and these included cases initially diagnosed with complex FS but later developed febrile status epilepticus and died. Conclusion: Febrile seizures are a significant presentation in children. About half had associated hyponatremia which was associated with recurrent seizures though not significant. Those with complex FS had hyponatremia which was more significant with fever at presentation. Mortality occurred in those that had febrile encephalopathy.