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Does iron deficiency raise the seizure threshold?
N L Kobrinsky1, J Y Yager, M S Cheang
1Department of Pediatrics, University of North Dakota, Fargo.
Insights
Iron deficiency may protect against febrile seizures in children. Children with febrile seizures showed better iron status compared to those without, suggesting a potential protective effect of iron deficiency.
Area of Science:
- Pediatric Neurology
- Hematology
- Biochemistry
Background:
- Febrile seizures are common in children.
- Iron deficiency is a prevalent nutritional deficiency in pediatric populations.
- The relationship between iron status and seizure threshold is not fully understood.
Purpose of the Study:
- To investigate the association between iron status and the occurrence of febrile seizures in children.
- To determine if iron deficiency influences the seizure threshold in pediatric patients.
Main Methods:
- Prospective evaluation of iron sufficiency measures in 51 children presenting with febrile illness.
- Comparison of iron status indicators (free erythrocyte protoporphyrin, hemoglobin, hematocrit, MCV, MCH, platelet count) between children with and without febrile seizures.
- Adjustment for confounding factors including family history.
Main Results:
- Children with febrile seizures were significantly less likely to be iron deficient based on multiple biochemical markers.
- Lower prevalence of iron deficiency was observed in the febrile seizure group compared to controls (P < .01 for free erythrocyte protoporphyrin).
- This association remained significant after adjusting for family history.
Conclusions:
- Iron deficiency may have a protective effect against the development of febrile seizures in children.
- Further research is warranted to elucidate the mechanisms underlying this potential protective association.
- Clinical implications for iron supplementation strategies in at-risk populations should be considered.
Abstract:
To determine the effect of iron status on the seizure threshold, measures of iron sufficiency were prospectively evaluated in 51 children presenting to a pediatric emergency department with a febrile illness with (26) or without (25) an associated febrile seizure. A higher proportion of children from the febrile seizure group had a family history of mental retardation (5/26 versus 0/25, P = .02) or of previous febrile seizures (10/26 versus 2/23, P = .01). The two groups were otherwise comparable for age, sex, race, family history of afebrile seizures, temperature at presentation, white blood cell count, differential, and vitamin and antibiotic use. Patients with febrile seizures were less frequently iron deficient as defined by a free erythrocyte protoporphyrin level above 0.80 ng/L (2/23 versus 10/25, P < .01), hemoglobin concentration less than 110 g/L (1/26 versus 6/25, P < .03), hematocrit less than 0.30 L/L (0/22 versus 4/25, P < .02), mean corpuscular hemoglobin less than 20 pg (0/25 versus 3/24, P < .04), mean corpuscular volume less than 65 fL (0/26 versus 4/24, P < .02), and platelet count higher than 550 x 10(9)/L (0/26 versus 3/25, P < .04). This association was even stronger when adjusted for differences in family history. None of the patients in the febrile seizure group was being treated for iron deficiency at presentation, whereas three of 25 controls used an iron supplement (P < .04). Iron deficiency may protect against the development of febrile seizures.