Relationship between Changes in Serum Sodium Level and Seizures Occurrence in Children with Hypernatremic Dehydration

How to Cite This Article: Heydarian F, Rezaeian A. Relationship between Changes in Serum Sodium Level and Seizures Occurrence in Children with Hypernatremic Dehydration. Iran J Child Neurol. 2013 Autumn;7(4): 35- 40. ObjectiveTo assess any relationship between serum sodium changes and seizure occurrence in children aged 2 months to 5 years with hypernatremic dehydration. Materials & MethodsThis cross-sectional study was performed on 63 patients aged 2 months to 5 years from 20 March 2006 to 15 March 2012 at Ghaem Hospital and Dr. Sheikh Hospital in Mashhad, Iran. Patients were divided into 2 groups: case group with hypernatremic dehydration and seizure occurrence, and control group with hypernatremic dehydration and no seizures. ResultsThe mean age of patients was 10.38 (2-48) months. Thirteen patients had seizures, 11 out of them, before admission and 2 during hospital staying. Serum sodium level at admission in those 2 patients with seizure occurrence after hospitalization was 169 (158-180) mmol/L, and in 50 patients without seizure was 162.8 (148-207) mmol/l. Also, the rate of decrease of serum sodium levels in these 2 cases within the first 12 hours after admission was 1.12, and in those without seizure was 0.54 (mmol/L/hour), and it was 0.47 and 0.53 (mmol/l/hour) after 24 hours of admission, respectively. Severe dehydration was seen in 38.5% of cases and 14% of controls. ConclusionThere was not any relationship between changes in serum sodium level and seizure occurrence in children with hypernatremic dehydration. ReferencesOkumura A, Ishiguro Y, Sofue A, Suzuki Y, Maruyama K, Kubota T, et al. Treatment and outcome in patients with febrile convulsion associated with epileptiform discharges on electroencephalography. Brain Dev 2004;26(4):241-4.Heydarian F, Vatankhah H. The role of anemia n first simple febrile seizure in children aged 6 months to 5 years old. Neurosciences (Riyadh) 2012;17(3):226-9.Heydrian F, Ashrafzadeh F, Ghasemian A. Serum zinc level in patients with simle febrile seizure. Iran J Child Neurol 2010;4(2):41-4.Dad MI, Ismael GA, Al-Oufi AA, Al-Mohammadi AH. Clinical pattern of seizures in hospitalized children. Neurosciences (Riyadh) 2003;8(2):107-9.Heydarian F, Ashrafzadeh F, Kam S. Simple febrile seizure: The role of serum sodium levels in prediction of seizure occurrence during the first 24 hours, Iran J Child Neurol 2009;3;31-4.Robertson G, Carrihill M, Hatherill M, Waggir Z,Reynolds L, Argent A. Relationship between fluid management, changes in serum sodium and outcome in hypernatremia associated with gastroenteritis, J Paediatr Child Health 2007;43(4):291-6.De Petris L, Luchetti A, Emma F. Cell volume regulationand transport mechanisms across the brain blood barrier: Implications for the management of hypernatremic states. Eur J pediatr 2000;160(2):71-7.Ross O. The management of extreme hypernatremia secondary to salt poisoning in an infant. Pediatr Anesth 2000;10:110-5.Hatherill M. Rubbing salt in the wound. Arch Dis Child 2004;89(5):414-8.Moritz ML, Ayus JC. Prevention of hospital acquired hyponatremia: A case for using isotonic saline. Pediatrics 2003;111(2):227-30.Taylor D, Durward A. Pouring salt on troubled waters. Arch Dis Child 2004;89(5):411-4.Fang C, Mao J, Dai Y, Xia Y, Fu H, Chen Y, et al. Fluid management of hypernatremic dehydration to prevent cerebral edema: A retrospective case control study of 97 children in China. J Paediatr Child Health 2010;46(6):301-3.El-Bayoumi MA, Abdelkader AM, El-Assmy MMA, Alwakeel AA, El-Tahan HM. Normal saline is a safe initial rehydration fluid in children with diarrhea-related hypernatremia. Eur J Pediatr 2012;171(2):383-8.Arampatzis S, Frauchiger B, FiedlerGM, Leichtle AB, Buhl D, Schwarz C, et al. Characteristics, Symptoms, and Outcome of severe Dysnatremias Present on Hospital Admission. Am J Med 2012;125(11):1125.e1-1125.e7.Chisti MJ, Pietroni MA, Smith JH, Bardhan PK, Salam MA, Predictors of death in under-five children with diarrhea admitted to a critical care ward in an urban hospital in Bangladesh. Am J Med 2012;125(11):1125. e1-1125.e7.Moritz ML, Ayus JC Preventing neurological complications from dysnatremias in children. Pediatr Nephrol 2005;20(12):1687-700.