ผลการตรวจทางห้องปฏิบัติการในผู้ป่วยเด็กที่มาด้วยภาวะชักจากไข้แบบธรรมดาเปรียบเทียบกับผู้ป่วยเด็กที่มาด้วยภาวะชักจากไข้แบบซับซ้อนที่มารักษาในโรงพยาบาล 50 พรรษามหาวชิราลงกรณ: Laboratory Parameters in Children with Simple Febrile Seizures  Versus Complex Febrile Seizures in 50th Anniversary Mahavajiralongkorn Hospital

อัจฉรัตน์ กัลยา

Authors

อัจฉรัตน์ กัลยา โรงพยาบาล50พรรษามหาวชิราลงกรณ

Keywords:

Keyword: Febrile seizures, Laboratory findings, Seizure-associated factors, Pediatric patients

Abstract

Abstract

Background: Febrile seizures are the most common neurological disorder in children aged 6 months to 5 years and can have significant effects, especially when recurrent, on both the child and their family.

Objective: To 1) determine the incidence of pediatric febrile seizures 2) compare the demographic characteristics and laboratory findings of pediatric patients with simple febrile seizures (SFS) and complex febrile seizure (CFS) at the Department of Pediatrics, 50 Pansa Mahawachiralongkorn Hospital

Methods: This retrospective analytical study included 259 pediatric seizure cases admitted between October 1, 2021 to September 30, 2025, at the Department of Pediatrics, 50 Pansa Mahawachiralongkorn Hospital. Clinical and laboratory data were collected from medical records. Descriptive statistics were used to summarize patient characteristics and incidence, Chi-square test, T-test and Mann-Whitney U test used to identify associated factors.

Results: A total of 259 pediatric patients were admitted with febrile seizure,representing 13.12% of all patients, the distribution of seizure types was 76.45% for SFS and 23.55% for CFS. In the SFS group, most patients were male (63.64%), older than 1 year (75.25%), and had no underlying diseases (93.94%), the majority experienced a first seizure episode (71.21%). In the CFS group, most patients were male (57.38%), older than 1 year (69.69%), and had no underlying diseases (93.44%), the majority experienced a first seizure episode (68.85%). Asthma was the most common comorbidity in the SFS group, whereas cerebral palsy predominated in the CFS group. Upper respiratory tract infection was the leading cause of febrile seizures in the SFS group, while fever of unknown origin was most common in the CFS group. Factors associated with seizure type showed that the mean serum chloride (Cl) level was significantly higher in the CFS group (88.04 ± 34.71) than in the SFS group (79.42 ± 40.95) (p = 0.033), the mean lymphocyte levels was significantly higher in the CFS group (32.26 ± 14.48) than in the SFS group (28.57 ± 15.80) (p = 0.032).

Conclusion: Significantly elevated Cl and lymphocyte levels were found in patients with CFS

Keyword: Febrile seizures, Laboratory findings, Seizure-associated factors, Pediatric patients

References

เอกสารอ้างอิง

Eilbert W, Chan C. Febrile seizures: A review. J Am Coll Emerg Physicians Open 2022; 3(4): e12769. doi: 10.1002/emp2.12769. PubMed PMID: 36016968.

Sawires R, Buttery J, Fahey M. A review of febrile seizures: Recent advances in understanding of febrile seizure pathophysiology and commonly implicated viral triggers. Front Pediatr 2022; 9: 801321. doi: 10.3389/fped.2021.801321. PubMed PMID: 35096712.

Alhammdi SI, Haroun SAB, Alshamsi FAS, Almheiri M, Al Hussami J, Latif T, et al. Neurodevelopmental outcomes in children with febrile seizures: A meta-analysis. Journal of Population Therapeutics and Clinical Pharmacology 2025; 32(2): 768-90. doi: 10.53555/9ea6q364.

Ferretti A, Riva A, Fabrizio A, Bruni O, Capovilla G, Foiadelli T, et al. Best practices for the management of febrile seizures in children. Ital J Pediatr 2024; 50(1): 95. doi: 10.1186/s13052-024-01666-1. PubMed PMID: 38735928.

Marangoni MB, Corsello A, Cozzi L, Agostoni C, Santangelo A, Milani G P, et al. The non-clinical burden of febrile seizures: A systematic review. Front Pediatr 2024; 12: 1377939. doi: 10.3389/fped.2024.1377939. PubMed PMID: 38711493.

Keum HR, Lee SJ, Kim JM, Kim SW, Baek HS, Byun JC, et al. Seasonal trend of viral prevalence and incidence of febrile convulsion: A Korea public health data analysis. Children 2023; 10(3): 529. doi: 10.3390/children10030529. PubMed PMID: 36980087.

Sithinamsuwan P, Apiwattanakul M, Wongsinin T, Sukajintanakarn D, Luangdilok P, Suttha P, et al. Seizures in Coronavirus Disease-2019 in Thailand: Case series survey. Southeast Asian J Trop Med Public Health 2020; 51(5): 709-18.

คณิตา อิสระภักดีรัตน์. ความชุกและปัจจัยเสี่ยงที่มีผลต่อการเกิดภาวะไข้ชักซ้ำหลังจากไข้ชักครั้งแรกในผู้ป่วยเด็ก โรงพยาบาลสวรรค์ประชารักษ์. วารสารวิชาการแพทย์และสาธารณสุข เขตสุขภาพที่ 3 พฤษภาคม-สิงหาคม 2565; 19(2): 155-67.

Yi Y, Zhong C, Wei-Wei, H. The long-term neurodevelopmental outcomes of febrile seizures and underlying mechanisms. Front Cell Dev Biol 2023; 11: 1186050. doi: 10.3389/fcell.2023.1186050. PubMed PMID: 37305674.

Skotte L, Fadista J, Bybjerg-Grauholm J, Appadurai V, Hildebrand MS, Hansen TF, et al. Genome-wide association study of febrile seizures implicates fever response and neuronal excitability genes. Brain 2022; 145(2): 555-68. doi: 10.1093/brain/awab260. PubMed PMID: 35022648.

Lu L, Huang H, Ding Z, Lin Z, Lv X, Gan T. A study on the distribution of interleukin-10 gene polymorphisms and their association with febrile seizure susceptibility in children from the Wenzhou region, Zhejiang Province. Front Public Health 2025; 13: 1645018. doi: 10.3389/fpubh.2025.1645018. PubMed PMID: 40832036.

Ngamjarus C, Chongsuvivatwong V, McNell E. n4Studies: Sample size calculation for an epide-miological study on a smart device. Siriraj Med J 2016; 68: 160-70.

Israel GD. Determining sample size. Institute of food and agricultural sciences (IFAS), University of Florida, PEOD-6 2013; 1-5.

Aydın H, Bucak İ, Bucak İH. Comparison of laboratory parameters between children with and without febrile convulsion. J Surg Med 2021; 5(2): 149-52. doi: 10.28982/josam.740090.

Balikoğlu P, Oflu A, Bükülmez A. Neutrophil-lymphocyte ratio, red cell distribution width and mean platelet volume as practical markers in febrile seizure classification. Rev Paul Pediatr 2023; 42: e2023016. doi: 10.1590/1984-0462/2024/42/2023016. PubMed PMID: 37937678.

Yalçın G, Ersen A, Anıl M. Evaluation of laboratory parameters in febrile seizure types. Neurology Asia 2023; 28(2): 283-90. doi: 10.54029/2023ysm.

Gontko-Romanowska K, Żaba Z, Panieński P, Steinborn B, Szemień M, Łukasik-Głębocka M, et al. The assessment of laboratory parameters in children with fever and febrile seizures. Brain Behav 2017; 7(7): e00720. doi: 10.1002/brb3.720. PubMed PMID: 28729928.

Sadri H, Madanipour A, Toami N, Bakhtiari M, Montazerlotfelahi H, Zahmatkesh E, et al. A survey on the association of seizure disorders with asthma and allergies in children. Eur Ann Allergy Clin Immunol 2024; 56(6): 263-70. doi: 10.23822/EurAnnACI.1764-1489.328. PubMed PMID: 38347809.

ภานุรัตน์ เชื้อเย็น. ผลการตรวจทางห้องปฏิบัติการในภาวะชักจากไข้ และปัจจัยเสี่ยงของการชักซ้ำใน 24 ชั่วโมง ในโรงพยาบาลอุตรดิตถ์. วารสารกุมารเวชศาสตร์ มกราคม-มีนาคม 2567; 63(1): 136-49.

Weiss SA. Chloride ion dysregulation in epileptogenic neuronal networks. Neurobiol Dis 2023; 177: 106000. doi: 10.1016/j.nbd.2023.106000. PubMed PMID: 36638891.

Cleveland Clinic. Hypochloremia [Internet]. 2026 [Cited 14 Apr 2026]. Available from: https://my.clevelandclinic.org/health/diseases/low-chloride-levels

Lajeo K, Sharma R, Kumar P. Clinical profile and laboratory parameters of febrile seizures: a hospital based cross-sectional study in sub-Himalayan region. Int J Contemp Pediatr 2023; 10(11): 1629-33. doi: 10.18203/2349-3291.jjcp2023229.

Rao A, Aroor AR. Evaluating the role of hemogram based parameters in febrile seizures. Int J Res Med Sci 2024; 12(2): 476-81. doi: 10.18203/2320-6012.ijrms20240214.

Varvel NH, Neherb JJ, Bosch A, Wanga W, Ransohoff RM, Miller RJ, et al. Infiltrating monocytes promote brain inflammation and exacerbate neuronal damage after status epilepticus. Proc Natl Acad Sci USA 2016; 113(38): E5665–74. doi: 10.1073/pnas.1604263113. PubMed PMID: 27601660.