Serum Sodium and Inflammatory Hematologic Indices as Predictors of Febrile Seizure Subtypes among Children in Southern Coastal Region Government Medical College Hospital, India

Abstract

Background: Febrile seizures (FS) are the most common neurological disorder in children and continue to cause worry for parents and caregivers. Clinical and lab assessments are important for identifying risk factors and guiding treatment. Objective: To evaluate the demographic, clinical, and lab characteristics of pediatric patients with febrile seizures, focusing on serum sodium and blood parameters. Methods: We conducted a prospective observational study in the Pediatric Inpatient Department of Government Medical College Hospital, Nagapattinam, from April to September 2024. We enrolled 250 pediatric patients aged 6 months to 12 years who presented with febrile seizures. We documented and statistically analyzed demographic features, clinical symptoms, birth history, family history, and lab tests (Hb, MCV, MCH, WBC, NLR, PLR, and serum sodium). Results: Among the 250 children, 162 (65%) were male and 88 (35%) female, with the highest occurrence between ages 1.5 and 2 years (28%). Simple febrile seizures were the most common (72%), followed by atypical seizures (14%), generalized tonic-clonic seizures (9%), and status epilepticus (5%). Fever (98%) and acute gastroenteritis (32%) were the leading causes. Anemia was found in 45% of the cases, with microcytic hypochromic changes (low Hb, MCV, and MCH). An elevated NLR was significantly linked to atypical seizures, while a reduced PLR was noted in simple seizures. Serum sodium abnormalities were found in 31% of patients (hyponatremia in 29%, hypernatremia in 2%), while 69% had normal sodium levels. Conclusion: This study confirms that febrile seizures are more common in boys and toddlers, with simple febrile seizures being the most frequent type. Hyponatremia and anemia were identified as major risk factors, and the NLR and PLR indices were useful for distinguishing seizure subtypes. We recommend routine evaluation of blood and electrolyte levels in patients with febrile seizures to allow for early risk identification and improved management.