Related Experiment Videos
Seizure from hyponatremia in infants. Early recognition and treatment
1Department of Family Practice, Memorial Medical Center Inc., Savannah, Ga.
Insights
Infants with hyponatremic seizures are younger and may have specific feeding practices. Early 3% saline bolus treatment is safe and effective for controlling seizures and reducing complications.
Area of Science:
- Pediatric Neurology
- Neonatal Medicine
- Clinical Chemistry
Background:
- Hyponatremia is a potential cause of seizures in infants.
- Identifying predictors and effective treatments for hyponatremic seizures is crucial for infant health.
Purpose of the Study:
- To identify predictors of hyponatremia in first-time infant seizures.
- To evaluate the efficacy and safety of 3% saline bolus for seizure control.
- To assess if early intervention reduces apnea-related complications.
Main Methods:
- Retrospective case series of 56 infants under 1 year with first-time seizures.
- Comparison of clinical characteristics and lab data between hyponatremic and non-hyponatremic seizure groups.
- Analysis of treatment strategies and outcomes for hyponatremic infants.
Main Results:
- 15% of infants experienced hyponatremic seizures, often associated with younger age, formula feeding with excessive solute-poor fluid, and lower body temperature.
- Hyponatremic seizures were more difficult to control, requiring more frequent intubation.
- Early 3% saline administration showed no adverse effects and reduced intubation rates compared to delayed or no treatment.
Conclusions:
- Key indicators for hyponatremic seizures include age < 6 months, specific feeding practices, and absence of fever or trauma.
- Bolus 3% saline is a safe and effective treatment for hyponatremic seizures.
- Early intervention with 3% saline can decrease morbidity associated with anticonvulsant therapy.
Objectives:
To determine whether history, vital signs, and physical examination may be used as predictors of hyponatremia in first-time seizure in infancy; to examine the efficacy and safety of 3% saline bolus administered to control seizures; and to determine whether early intervention reduces apnea-related complications.
Design:
Retrospective case series comparing clinical characteristics and initial laboratory data of infants with hyponatremic seizures and seizures of other categories. Treatment strategies and outcomes are examined in hyponatremic infants to determine the efficacy and safety of 3% saline administration.
Setting:
Tertiary care community medical center.
Participants:
Fifty-six consecutive infants under 1 year of age with first-time seizure.
Results:
Fifteen infants (27%) had hyponatremic seizure. They were younger and had lower body temperatures, higher serum glucose concentrations, and lower serum bicarbonate concentrations than infants with nonhyponatremic seizure (P < .05). All infants with hyponatremic seizure were formula fed; 13 (87%) had excessive solute-poor fluid. Hyponatremic seizures were more difficult to control and required more frequent intubation. Three of seven hyponatremic infants treated early with 3% saline required intubation. Six of eight infants who received delayed 3% saline solution or none required intubation. No adverse effects resulted from administration of hypertonic saline.
Conclusion:
Parameters for recognizing hyponatremic seizure include age less than 6 months; formula with solute-poor fluid; absence of significant medical history or recent febrile illness, hypothermia, hyperglycemia, status epilepticus, and absence of evidence of trauma. Bolus 3% saline was safe and effective in controlling hyponatremic seizure; early use reduced morbidity from anticonvulsant therapy.