Neurochemical Determinants of Febrile Seizure Susceptibility in Children

A bstract Purpose: This study aimed to assess and compare serum levels of sodium, calcium, and magnesium in febrile children with and without seizures, and to examine the neurochemical association between electrolyte imbalance and neuronal excitability. Materials and Methods: A prospective case–control study was conducted over 1 year in the Department of Pediatrics, including 200 children aged 6 months to 5 years, 100 with febrile seizures (FSs) and 100 age- and sex-matched febrile controls. Serum sodium, calcium, and magnesium levels were analyzed using an automated biochemistry analyzer. Data were compared using the independent-sample t test (Statistical Package for the Social Sciences, version 20.0; P < 0.05 considered significant). Results: Children with FSs had significantly lower serum sodium (135.5 ± 4.03 mmol/L), calcium (8.54 ± 0.33 mg/dL), and magnesium (1.81 ± 0.20 mg/dL) levels than controls (140.4 ± 2.78, 9.25 ± 0.51, and 2.07 ± 0.19, respectively; P < 0.001 for all). Most cases were under 2 years of age, and upper respiratory infections were the predominant cause of fever. No significant inter-electrolyte correlations were observed. Conclusion: Altered ionic homeostasis may be associated with transient changes in cortical excitability during febrile illness. Electrolyte evaluation may be considered in selected cases, such as prolonged or recurrent seizures; however, larger prospective outcome-based studies are required before universal routine screening can be recommended. Future studies integrating electrophysiological and neuroimaging correlates are warranted to elucidate the neurochemical mechanisms underlying FSs.