Afebrile Seizures;

Abstract

Background: Seizures are the most common neurologic emergency in pediatrics and can be terrifying for patients and families. They occur in approximately 4-10% of children and account for 1% of all emergency department visits. There are a variety of potential causes for seizures; however, they have a final common pathway which includes abnormal electrical discharges of neurons. The extent of this abnormal discharges and their location in the brain leads to a variety of clinical presentation which range from subtle, non-convulsive events to dramatic generalized convulsions. Most common biochemical abnormality causing seizures is hypocalcemia, which in children may manifest astetany, seizures, muscle cramp, and paresthesia. Objectives: The objective of the study was to: determine the frequency of hypocalcaemia in children presenting with afebrile seizures from age 2 months to 2 years. Study Design: Descriptive cross sectional study. Settings: Pediatric emergency and outpatient department of Pediatric Medicine Unit 1, Independent University Faisalabad. Period: Six months from 01.01.2018 to 30.06.2018. Methodology: After Approval from Ethical committee, 86 children presenting in pediatric emergency of Independent Hospital Faisalabad who meet the inclusion criteria were enrolled in this study. Detailed history and informed consent was obtained from parents of each patient presenting with first episode of afebrile seizure. Blood serum sample was sent to the hospital pathology laboratory for assessment of serum calcium. Routine investigations to rule out other causes of seizures were also done. All the data was recorded on a predesigned performa. Inclusion and exclusion criteria were strictly followed. Results: In this study, out of 86 cases, 55%(n=47) were between 2-12 months of age and 45%(n=39) were between 13-24 months of age, mean+sd was calculated as 12.33+5.27 months, maternal age shows that 72.24%(n=58) were between 18-30years of age and 30.76%(n=29) were between 31-45years of age, mean+sd was calculated as 29.52+3.70 years, 52.38%(n=44) were male and 47.62%(n=42) were females, frequency of hypocalcaemia in children presenting with afebrile seizures from age 2 months to 2 years was recorded in 66.48%(n=56) cases. Conclusion: We concluded that the frequency of hypocalcaemia is higher in children presenting with afebrile seizures from age 2 months to 2 years, and by controlling hypocalcemia, we may reduce the risk of seizures.

Frequency of Hypocalcemia in Breast Fed Infants Presenting with Afebrile Fits

“…There was a statistically significant (p=0.05) gender difference in the prevalence of hypocalcaemia between males (n=141) and females (n=69) in the current research. Gender differences in the frequency of hypocalcaemia in children were also shown to be statistically significant (p=0.05) in an earlier research (14).…”

“…These results were also consistent with those of prior investigations. In a research on the prevalence of hypocalcemia in children presenting with afebrile fits in Islamabad, Rehman et al (2019) found that boys accounted for 53.2% of the sample, while girls accounted for 47.6% (14). Sixty-four point five percent of children had a weightfor-age (WFA) below the fifth percentile, indicating malnutrition, and thirty-eight point five percent had a length-for-age (LFA) below the fifth percentile, also indicating malnutrition.…”

Frequency of Hypocalcaemia among Children (Age 2-60 Months) Presenting with First Episode of Afebrile Seizures: A Cross Sectional Study

“…In a British study nearly 20% had seizures which satisfied criteria for a 'simple febrile seizure' but they were also hypocalcemia [17]. In a similar local study frequency of hypocalcaemia in children presenting with afebrile seizures was 66.48 %( n=56) [18].…”