IRON DEFICIENCY AS A POTENTIAL RISK FACTOR FOR FEBRILE SEIZURES

Abstract

Background: Febrile seizures are the most common type of seizure disorder in childhood, affecting approximately 2–5% of children between 6 and 60 months of age. Iron plays an essential role in brain energy metabolism, neurotransmitter synthesis, myelination, and neuronal function. Iron deficiency may alter seizure threshold and has been proposed as a potential risk factor for febrile seizures. Objective: To evaluate iron deficiency in children with febrile seizures and to assess its association with first and recurrent febrile seizure episodes. Methods: This prospective observational study was conducted at the Indira Gandhi Institute of Child Health, Bengaluru, over a period of 12 months from January 2019 to December 2019. Sixty children aged 6–60 months diagnosed with febrile seizures according to the American Academy of Pediatrics criteria were enrolled. Thirty children had a first febrile seizure episode and thirty had recurrent febrile seizures. Detailed clinical history, physical examination findings, hematological parameters, peripheral smear findings, and iron profile including serum ferritin, serum iron, total iron-binding capacity (TIBC), and transferrin saturation (TSAT) were recorded and analyzed. Results: The mean age at presentation was 15.7 months in children with first febrile seizures and 27.9 months in those with recurrent febrile seizures. Serum ferritin, serum iron, and transferrin saturation levels were significantly lower in children with recurrent febrile seizures compared with first febrile seizure cases and controls. Mean serum iron levels were 34.9 µg/dL in first febrile seizures, 26.9 µg/dL in recurrent febrile seizures, and 154.2 µg/dL in controls (p<0.001). Similarly, transferrin saturation was significantly lower in recurrent febrile seizures (8.5%) than in first febrile seizures (9.7%) and controls (45.63%) (p<0.001). Hematological indices suggestive of iron deficiency, including MCH and MCHC, were also significantly reduced among children with febrile seizures. Conclusion: Iron deficiency appears to be an important and potentially modifiable risk factor for febrile seizures, particularly recurrent febrile seizures. Routine evaluation of iron status in children presenting with febrile seizures may facilitate early identification and treatment of iron deficiency, potentially reducing the risk of recurrence.