Etiological Clinical and Laboratory Profile of Children admitted with Febrile Seizures in a Tertiary Care Hospital of Western Nepal

Abstract

Introduction: Febrile seizures are the most common seizure disorder in childhood and are a frequent cause of hospital admission. Information regarding the demographic, clinical, etiological, and laboratory characteristics of febrile seizures in Nepal remains limited. This study aimed to evaluate the demographic, etiological, clinical, and laboratory profile of children admitted with febrile seizures in a tertiary care hospital in Western Nepal.
Materials and Methods: A hospital-based prospective observational study was conducted at Siddhartha Children and Women Hospital, Butwal, from September 2023 to September 2025. Children aged 6–60 months admitted with febrile seizures were enrolled consecutively. Demographic characteristics, clinical features, etiological diagnosis, and laboratory parameters were recorded. Febrile seizures were classified as simple or complex according to standard criteria. Data were analysed using SPSS version 26. Descriptive statistics were used to summarize the data, and the Chi-square test was applied to assess associations between variables. A p-value <0.05 was considered statistically significant.
Results: A total of 77 children were included in the study. Boys comprised 55.8% of participants, and the mean age was 26.7 ± 12.2 months. Generalized tonicclonic seizures were the most common seizure type (80.5%). Simple febrile seizures accounted for 66.2% of cases, whereas 33.8% were classified as complex febrile seizures. Acute respiratory infection was the most common etiology (57.1%), followed by fever without source (18.2%), urinary tract infection (13.0%), and dengue fever (11.7%). A previous history of febrile seizures was present in 31.2% of children, and 27.3% had a positive family history. Anemia, leukocytosis, and hyponatremia were observed in 93.5%, 62.3%, and 24.7% of participants, respectively. Etiology (p=0.0012) and family history of febrile seizures (p=0.036) showed significant associations with seizure classification, whereas age, sex, anemia, leukocytosis, hyponatremia, and fever at presentation did not.
Conclusion: Febrile seizures predominantly affected children aged 13–36 months and were more common in boys. Generalized tonic-clonic seizures and acute respiratory infections were the predominant clinical and etiological findings. Significant associations were observed between seizure classification, etiology, and family history. Larger multicenter studies with long-term follow-up are needed to further evaluate factors associated with seizure characteristics and outcomes.