Utility of laboratory tests for children in the emergency department with a first seizure

Area of Science:

• Neurology
• Emergency Medicine
• Clinical Chemistry

Background:

• First-time seizures in the emergency department (ED) necessitate evaluation for underlying causes.
• Laboratory testing, including serum electrolytes and glucose, is standard for these patients.
• Identifying factors associated with abnormal lab results can guide diagnostic approaches.

Purpose of the Study:

• To investigate factors linked to abnormal laboratory findings in patients presenting with their first seizure.
• To determine if demographic, clinical, or seizure characteristics correlate with abnormal serum sodium, potassium, calcium, or glucose levels.

Main Methods:

• A cohort of 240 patients with first seizures presenting to the ED was analyzed.
• Patients were grouped based on normal versus abnormal serum levels of sodium, potassium, calcium, and glucose.
• Associated factors including age, sex, fever, gastrointestinal symptoms, and seizure characteristics were evaluated.

Main Results:

• Abnormalities were frequent, particularly for glucose (52.3%) and sodium (34.8%).
• No significant associations were found for sodium or calcium abnormalities with evaluated factors.
• Abnormal glucose levels correlated with longer seizure duration (P=0.005), and abnormal potassium with patient age (P=0.002).

Conclusions:

• While electrolyte abnormalities showed no clear associations with common clinical factors, abnormal glucose levels may indicate prolonged seizures.
• Further research is needed to identify specific factors guiding laboratory testing in first-seizure patients.
• Current clinical factors do not reliably predict abnormal laboratory findings in this population.