Clinical, epidemiological and laboratory characteristics of children with febrile seizures

Abstract

Background: Febrile seizures are the most common seizure disorder in early childhood and represent a frequent cause of pediatric emergency visits. Understanding their clinical, epidemiological, and laboratory characteristics is essential for appropriate evaluation and management.

Methods: A hospital-based observational study was conducted from March 2024 to February 2026 at Kempegowda Institute of Medical Sciences and Research Centre, Bengaluru, after institutional ethics committee approval. Sixty-five children aged 6-60 months presenting with febrile seizures were enrolled. Children with afebrile seizures, central nervous system infections, congenital CNS malformations, or chronic illnesses were excluded. Demographic details, clinical characteristics, and laboratory parameters, including complete blood count, serum electrolytes, blood glucose, C-reactive protein, and urine examination, were recorded. Data were analyzed using descriptive statistics, Chi-square test, fisher's exact test, and independent t-test or Mann-Whitney U test as appropriate. Effect sizes were reported as Cramer's V for categorical associations, with 95% confidence intervals (CI). A p value of <0.05 was considered statistically significant. Statistical analysis was performed using IBM statistical package for the social sciences (SPSS) statistics version 26.0 (IBM Corp., Armonk, NY, USA). Normality of continuous variables was assessed using the Shapiro-Wilk test.

Results: The mean age was 25.02±14.75 months, with most children aged 24-35 months (22/65, 33.8%). Males constituted 41/65 (63.1%) of cases. Most children presented with fever of 100-101 F (30/65, 46.2%), and 56/65 (86.1%) developed seizures within two days of fever onset. A single convulsion occurred in 46/65 (70.8%) of children. Hematological evaluation showed mild anaemia (mean hemoglobin 10.64±1.58 g/dl), leukocytosis (mean total leukocyte count 12,684.86±5,463.75 cells/mm³), and neutrophil predominance. Biochemical parameters were largely within normal limits except for mild hyponatremia (mean serum sodium 134.89±2.70 mEq/l). Urine abnormalities were detected in 11/65 (16.9%) of cases. Lower hemoglobin levels were significantly associated with multiple convulsions (Fisher's exact test, p=0.015, Cramer's V=0.368, 95% CI: 0.102-0.583).

Conclusions: In this study, febrile seizures predominantly occurred in neurologically normal children below three years of age and were usually associated with short-duration fever and single seizure episodes. Mild anaemia was common and was significantly associated with seizure recurrence, suggesting its potential role as a clinically relevant laboratory marker in children with febrile seizures.