چكيده لاتين :
Objective
Most children brought to the emergency department (ED) for evaluation
of seizures undergo an extensive laboratory workup. Since results are
usually negative, the value of such routine laboratory workups has been
questioned. A group of children with unprovoked seizures was
prospectively studied to determine the diagnostic values of routine
serum chemistries and to identify risk factors predictive of abnormal
findings.
Materials & Methods
All patients evaluated at the ED of the Ghaem hospital during a
consecutive 12 months period between Jan 2004 through Jan 2005
were studied. We collected data for patientיs demographics, details of
the history of present illness (including vomiting, diarrhea, apnea) ,
medication use, past history of seizures, family history of seizures,
metabolic disorders or other chronic medical illnesses, neonatal history
and neurological examination as well as nutritional status, type and
time of seizure. The role of abnormal serum chemistries as a seizure
trigger factor was assessed in patients with a history of seizure.
Results
A total of 210 patients (mean age 19 .2 months) with unprovoked
seizureswere evaluated. Twenty- three serum abnormalities were noted
in the patients (12 cases of hyponatremia, 7 of hypoglycemia, 4 of
hypokalemia, 4 of uremia). The incidence of abnormal serum biochemical
values was higher in patients with a first seizure, younger patients, and
those with gastrointestinal symptoms.
Conclusion
According to the present study, one can conclude that in children
younger than 2 years and having no structural CNS abnormality,
electrolyte and glucose screening is recommended only for a first
unprovoked seizure, when gastrointestinal symptoms or symptoms
suggesting electrolyte disturbances are present.
