Objective: Febrile convulsion in children is age-dependent and genetic predisposition. However, mild electrolyte disturbances are not uncommon in such children. This study was to investigate the effect of electrolyte disturbance on febrile convulsion and to screen for febrile convulsion-related genes. Methods: This retrospective cohort study included children who admitted to the Pediatric Emergency Department of Guangzhou Women and Children’s Medical Center due to fever and febrile convulsion between May to December 2020. Clinical manifestations and serum electrolyte levels were recorded and analyzed by binary logistic regression on risk factors of convulsion, and children with family histories were screened for febrile convulsion-related genes. Results: This study included 322 children with fever: 161 in the febrile convulsion group (FC Group) including 71 in the single convulsion group (SC Group) and 90 in the multiple convulsion group (MC Group), and the control group consisted of 161 children with fever without convulsion and nervous system disease. Serum sodium, potassium and calcium in FC Group were lower than those in the control group (p < 0.05), but blood glucose was higher (5.7 mmol/L vs. 5.2 mmol/L, p = 0.01); meanwhile, the threshold of serum sodium level in convulsion was 133 mmol/L [Sensitivity: 70.2%, Specificity: 62.1%, AUC: 0.694, p < 0.001]. In the FC Group, there were no significant differences in serum sodium, calcium and chlorine between SC Group and MC Group, but lower level of blood glucose in the MC Group (5.6 mmol/L vs. 5.9 mmol/L, p = 0.008). Although univariate analysis showed that serum sodium, potassium, calcium, and sugar levels were associated with febrile convulsion, only serum sodium was below normal values. There was no pathogenicity variation related to disease phenotype was found in 5 FC patients with family histories, but four of them found other mutations. Conclusion: Hyponatremia may be a relative risk factor in febrile convulsion, and for children with a family history of febrile convulsion and serum sodium lower than 133 mmol/L, related gene analysis can be performed.
KeywordsFebrile ConvulsionElectrolyteRecurrence of ConvulsionHyponatremiaFamily HistoryGene
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