Articles

Leukocyte Count and Erythrocyte Sedimentation Rate as Diagnostic Factors in Febrile Convulsion

Abstract

Febrile convulsion (FC) is the most common seizure disorder in childhood. white blood cell (WBC) and erythrocyte sedimentation rate (ESR) are commonly measured in FC. Trauma, vomiting and bleeding can also lead to WBC and ESR so the blood tests must carefully be interpreted by the clinician. In this cross sectional study 410 children(163 with FC), aged 6 months to 5 years, admitted to Bahrami Children hospital in the first 48 hours of their febrile disease, either with or without seizure, were evaluated over an 18 months period. Age, sex, temperature; history of vomiting, bleeding or trauma; WBC, ESR and hemoglobin were recorded in all children. There was a significant increase of WBC (P<0.001) in children with FC so we can deduct that leukocytosis encountered in children with FC can be due to convulsion in itself. There was no significant difference regarding ESR (P=0.113) between the two groups. In fact, elevated ESR is a result of underlying pathology. In stable patients who don't have any indication of lumbar puncture, there's no need to assess WBC and ESR as an indicator of underlying infection. If the patient is transferred to pediatric ward and still there's no reason to suspect a bacterial infection, there is no need for WBC test.

Auvin S, Vallée L. Febrile seizures: current understanding of pathophysiological mechanisms. Arch Pediatr 2009;16(5):450-6.

Shinnar S. Febrile seizures. In: Swaiman KF, Ashwal S, Ferriero DM, editors. Pediatric Neurology: Principles and Practice. 4th ed. Philadelphia: Mosby; 2006. p. 1079-86.

Verity CM, Butler NR, Golding J. Febrile convulsions in a nnational cohort followed up from birth. I: Prevalence and recurrence in the first five years of life. Br Med J (Clin Res Ed) 1985;290(6478):1307-10.

Rosman NP. Febrile seizures. In: Pellock J, Dodson W, Bourgeois B, editors. Pediatric Epilepsy: Diagnosis and Therapy. 2nd ed. New York, NY: Demos Medical Publishing; 2001. p. 163-5.

van Zeijl JH, Mullaart RA, Galama JM. The pathogenesis of febrile seizures: is there a role for specific infections? Rev Med Virol 2002;12(2):93-106.

Hong SA, Kim SH, Lee SL, Kim JS. Influencing factors on duration and frequency of febrile convulsion. J Korean Child Neurol Soc 2002;10(1):87-93.

Millichap JG, Millichap JJ. Role of viral infections in the etiology of febrile seizures. Pediatr Neurol 2006;35(3):165-72.

Aicardi J. Febrile convulsions. In: Aicardi J, editor. Epilepsy in Children. 2nd ed. New York: Raven Press; 1994. p. 253-76.

Subcommittee on Febrile Seizures; American Academy of Pediatrics. Neurodiagnostic evaluation of the child with a simple febrile seizure. Pediatrics 2011;127(2):389-94.

Mohebbi MR, Holden KR, Mohammadi M. Peripheral leukocytosis in children with febrile seizures. J Child Neurol 2004;19(1):47-50.

van Stuijvenberg M, Moll HA, Steyerberg EW, van Gijssel EN, Moons KG, Derksen-Lubsen G. The duration of febrile seizures and peripheral leukocytosis. J Pediatr 1998;133(4):557-8.

Warden CR, Zibulewsky J, Mace S, Gold C, Gausche-Hill M. Evaluation and management of febrile seizures in the out-of-hospital and emergency department settings. Ann Emerg Med 2003;41(2):215-22.

Toyosawa K. Changes of peripheral leukocyte-counts by electrically induced convulsion in rabbits (author's transl). Nihon Seirigaku Zasshi 1975;37(10):297-306.

McCarthy PL, Jekel JF, Dolan TF Jr. Comparison of acutephase reactants in pediatric patients with fever. Pediatrics 1978;62(5):716-20.

Files
IssueVol 49, No 7 (2011) QRcode
SectionArticles
Keywords
Seizures febrile Erythrocyte sedimentation rate Leukocytosis

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Rahbarimanesh AA, Salamati P, Ashrafi M, Sadeghi M, Tavakoli J. Leukocyte Count and Erythrocyte Sedimentation Rate as Diagnostic Factors in Febrile Convulsion. Acta Med Iran. 1;49(7):447-450.