Association between serum neuron-specific enolase levels and short-term brain injury in pediatric febrile convulsions: A cross-sectional study

This study aims to investigate the association between serum neuron-specific enolase (NSE) concentrations and acute brain injury in children experiencing febrile convulsions. This cross-sectional study involved 120 children aged 6 months to 6 years with febrile convulsions from January 2021 to December 2023. Children were categorized into brain injury and non-brain injury groups based on electroencephalogram findings or neurological symptoms within 48 hours post-seizure. Serum NSE levels were measured using enzyme-linked immunosorbent assay. Logistic regression analyses were conducted to assess the association between NSE levels and brain injury, with adjustments for age, body temperature, number of convulsive episodes, and seizure duration. Subgroup analyses were performed based on convulsive episodes (<2 vs ≥2) and seizure duration (<10 minutes vs ≥10 minutes). Short-term brain injury was observed in 30% of the children. Elevated serum NSE levels were significantly associated with brain injury (odds ratio [OR]: 4.2, 95% confidence interval [CI]: 2.1-8.4, P < .001 in univariate analysis; OR: 3.8, 95% CI: 1.9-7.6, P < .001 in multivariate analysis). The association was particularly strong in children with ≥2 convulsive episodes (OR: 4.5, 95% CI: 1.9-10.7, P = .001) and prolonged seizures (≥10 minutes, OR: 6.0, 95% CI: 2.3-15.8, P < .001). Elevated serum NSE levels were associated with acute electroencephalogram or imaging indicators of brain injury in children with febrile convulsions, especially in those with repeated or prolonged seizures.