Evaluation of Serum Electrolyte Profile in Children Presenting With Febrile Seizures: A Cross-Sectional Study in a Tertiary Care Teaching Hospital

Abstract

Introduction: Febrile seizures are the most common neurological emergency in early childhood, typically occurring between 6 and 60 months of age. While simple febrile seizures are self-limiting, complex febrile seizures and recurrences cause significant parental anxiety and potential morbidity. Serum electrolytes, particularly sodium and calcium, play crucial roles in maintaining neuronal membrane stability and excitability during febrile episodes. Aim: To measure serum electrolyte levels (sodium, potassium, and total calcium) in pediatric patients presenting with febrile seizures and to evaluate their association with seizure type (simple vs. complex) and patient sex. Materials and Methods: This cross-sectional study was conducted in the Department of Pediatrics at Koppal Institute of Medical Sciences (KIMS), Koppal, Karnataka, over a 12-month period from April 2024 to March 2025. A total of 110 pediatric patients aged 6 to 60 months meeting inclusion criteria were enrolled. Venous blood samples were collected at presentation for serum electrolyte estimation using an automated ion-selective electrode method. Statistical analysis was performed using SPSS version 26.0 software, employing Fisher’s exact test and Pearson’s Chi-square test, with p < 0.05 considered statistically significant. Results: Of the 110 study subjects, 62 (56.36%) were male and 48 (43.64%) were female (M:F ratio = 1.29:1). Simple febrile seizures were observed in 98 (89.09%) cases, while 12 (10.91%) exhibited complex febrile seizures. Hyponatremia (<135 mEq/L) was noted in 31 (28.18%) patients. A statistically significant association was found between serum sodium levels and seizure type (p = 0.018) as well as serum total calcium levels and patient sex (p = 0.024). No significant association was observed for serum potassium with sex (p = 0.612) or seizure type (p = 0.745). Conclusion: Electrolyte abnormalities—specifically hyponatremia and total hypocalcemia—are common in children presenting with febrile seizures. Measuring serum electrolytes at presentation is easy, rapid, and provides quantifiable parameters that can aid acute clinical decision-making and risk stratification.