Febril nöbette hiponatreminin önemi
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Date
2020-02-15
Authors
Dilber, Beril
Arslan, Elif Acar
Şahin, Sevim
Esenülkü, Gülnur
Kart, Pınar Özkan
Cansu, Ali
Journal Title
Journal ISSN
Volume Title
Publisher
Bursa Uludağ Üniversitesi
Abstract
Febril nöbet çocukluk çağında en sık görülen nörolojik durumdur. Basit, komplike ve febril status olarak görülür. Uzamış febril nöbet ve komplike febril nöbet başta olmak üzere beyinde hasarlanmalar yaratır ve elektrolit bozuklukları bu durumun ağırlaşmasına ve nöbet tekrarlamasına neden olabilir. 2014- 2018 yılları arasında çocuk bölümüne başvuran toplam 6-72 ay arası 537 çocuk (273 çocuk febril nöbet; 264 çocuk ise nöbet olmadan ateş) çalışmaya dahil edildi. Hastalar iki gruba; basit febril nöbet (BFN) ve komplike febril nöbet (KFN) olarak ayrıldı. tek nöbet 15 dakikanın altında fokalite göstermeyen; KFN ise >15 dakika ve fokalite gösteren 24 saat içinde birden çok kez tekrarlayan nöbet olarak alındı. Febril nöbetle başvuru anında elektrolit değerleri venöz kan örnekleri ile değerlendirildi. BULGULAR: : Hastaların yaştan ve cinsiyetten bağımsız olarak lojistik regresyon analizi yapıldığında sodyum değeri <134,5 olanlara göre sodyum değeri ≥ 134,5 olanlar febril nöbet riski açısından 10,13 kat daha riskli bulundu. Serum potasyum ve kalsiyum değerleri arasında anlamlı bir ilişki bulunamadı. Febril nöbet geçiren hastaların %66.3‘ünün ve de KFN geçiren hastaların %64’ünün sodyum değeri 134.5 mmol/L altında idi. Crosstabs sodyum için sensivite %66,3 spesifite %83,7 pozitif prediktif değer %80,8 negatif %70,6 idi. Ilımlı hiponatremi değerleri (132-133) olan hastaların nöbet sıklıkları diğer sodyum düzeylerine göre nöbet sıklığındaki artışla orantılı idi (r=0,389, r=0,434, p<0,05). Bu çalışmamızda; febril nöbette sodyum değerlerinin anlamlı olarak düştüğünü, komplike febril nöbeti olan çocuklarda sodyum düşüklüğünün belirgin olduğunu ve nöbetin tekrarlamasında belirleyici risk faktörü olduğunu gösterdik.
Febrile seizure is most common neurological condition in childhood. It is seen as simple, complex febrile seizure and febrile status. Prolonged febrile seizure and electrolyte disturbances cause this condition to worsen and relaps. Between 2014 and 2018, 537 children (273 children with febrile seizures and 264 children with fever without seizures) were included in the study. Patients were divided into two groups; simple febrile seizure (BFN) and complex febrile seizure (CFN). BFN; single seizure not showing focalness less than 15 minutes; CFN was taken as a recurrent seizure multiple times within> 15 minutes and 24 hours with focal. Electrolyte values were evaluated with venous blood samples at admission with febrile seizures When logistic regression analysis was performed, regardless of age and gender, patients with sodium values <134.5 were found to be 10.13 times more risky for febrile seizures than those with sodium values <134.5. There was no significant relationship between serum potassium and calcium levels. 66.3% of patients with febrile seizures and 64% of patients with CFN had a sodium value below 134.5 mmol / L. The sensitivity and specificity for crosstabs sodium were 66.3% and 83.7%, and the positive predictive value was 80.8% and 70.6%, respectively. Seizure frequency of patients with moderate hyponatremia (132-133) was proportional to increase in seizure frequency compared to other sodium levels (r = 0.389, r = 0.434, p <0.05). In this study; We showed that sodium levels decreased significantly in febrile seizure, low sodium was significant in children with complex febrile seizures and it was a determining risk factor for recurrence of seizures.
Febrile seizure is most common neurological condition in childhood. It is seen as simple, complex febrile seizure and febrile status. Prolonged febrile seizure and electrolyte disturbances cause this condition to worsen and relaps. Between 2014 and 2018, 537 children (273 children with febrile seizures and 264 children with fever without seizures) were included in the study. Patients were divided into two groups; simple febrile seizure (BFN) and complex febrile seizure (CFN). BFN; single seizure not showing focalness less than 15 minutes; CFN was taken as a recurrent seizure multiple times within> 15 minutes and 24 hours with focal. Electrolyte values were evaluated with venous blood samples at admission with febrile seizures When logistic regression analysis was performed, regardless of age and gender, patients with sodium values <134.5 were found to be 10.13 times more risky for febrile seizures than those with sodium values <134.5. There was no significant relationship between serum potassium and calcium levels. 66.3% of patients with febrile seizures and 64% of patients with CFN had a sodium value below 134.5 mmol / L. The sensitivity and specificity for crosstabs sodium were 66.3% and 83.7%, and the positive predictive value was 80.8% and 70.6%, respectively. Seizure frequency of patients with moderate hyponatremia (132-133) was proportional to increase in seizure frequency compared to other sodium levels (r = 0.389, r = 0.434, p <0.05). In this study; We showed that sodium levels decreased significantly in febrile seizure, low sodium was significant in children with complex febrile seizures and it was a determining risk factor for recurrence of seizures.
Description
Keywords
Febril nöbet, Febrile seizures, Hiponatremi, Sodyum düzeyi ve nöbet tekrarı, Hyponatremia, Sodium levels and recurrence of seizures
Citation
Dilber, B. (2020). "Febril nöbette hiponatreminin önemi". Güncel Pediatri Dergisi, 18(1), 53-62