Meteorological factors and daily afebrile seizure counts in children: a time-series analysis

Abstract Background The relationship between meteorological factors and seizure occurrence remains controversial, particularly in pediatric populations where data are limited and may be confounded by febrile seizures. This study aimed to investigate the association between daily meteorological variables and afebrile seizure occurrence in children using a multivariable time-series approach. Methods This retrospective observational study included children presenting with afebrile seizures to a tertiary university hospital in Ankara, Türkiye, between April 2017 and April 2021. Daily seizure counts were linked with meteorological data obtained from a weather station located approximately 2 km from the hospital. Associations between meteorological variables and daily afebrile seizure counts were evaluated using generalized additive models within a Poisson regression framework, incorporating distributed lag structures (lag 0–3 days) and adjustment for calendar time and weekday. Results A total of 494 eligible afebrile seizure presentations among 429 children were included. During the study period, seizures occurred on 396 of 1,491 calendar days. After adjustment for temporal trends, delayed effects, and multiple meteorological variables, no independent associations were identified between daily afebrile seizure counts and mean temperature, atmospheric pressure, relative humidity, wind speed, temperature range, pressure range, or wind direction (all p > 0.05). The smooth term for calendar time was significant ( p < 0.001), indicating underlying temporal variation in daily seizure counts that was not explained by the evaluated meteorological variables. Conclusions In this four-year pediatric cohort, meteorological variables were not independently associated with daily afebrile seizure counts after accounting for temporal trends and delayed effects. These findings highlight the importance of appropriate time-series analytical methods when investigating potential environmental factors associated with seizure occurrence. Further prospective multicenter studies incorporating additional environmental exposures and individual-level clinical factors are warranted.