Clinical and Laboratory Presentations of Children with First Time Febrile Seizure: Findings from a Tertiary Level Hospital in Bangladesh

Abstract

Background: Seizures associated with fever are a leading cause of pediatric hospitalization. The purpose of this study was to explore the clinical characteristics and laboratory findings of children with first time febrile seizure in local settings, which are limited in Bangladesh. Methods: From July 2013 to June 2014, this Cross-sectional, Observational study was conducted at Sir Salimullah Medical College and Mitford Hospital in Dhaka. The study included all admitted children aged 6 months to 60 months who had their first febrile seizure. A thorough history, clinical examination, and laboratory investigations were performed and analyzed. Results: Among the 87 study population, mean age of presentation was 25.62 ± 12.64 months, male were predominant (56%) and 17% had family history of FS. Majority of them presented with respiratory illness-like symptoms(23%). 54% of them experienced two seizures, and 75% of the seizures were generalised. 23% of them revealed chest X-ray features consistent with lung infection, 31% had neutrophilic leukocytosis, and 8% had positive blood culture growth. Streptococcus pneumoniae in Gram stain of 2% CSF and Klebsiella in 2% of the CSF culture cases were identified. Pneumonia was the underlying cause in 20% of case; viral syndrome in17% of cases, meningitis in 13% of cases, and in 15% of cases, the underlying cause could not be identified. Conclusion: The majority of febrile seizures in our study participants were caused by various respiratory illnesses and meningitis. White blood cell counts, blood culture and cerebrospinal fluid analyses can aid in determining the underlying cause and facilitating appropriate and timely management.