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Research Paper | Pediatrics | India | Volume 12 Issue 2, February 2023

Neutrophil Lymphocyte Ratio as a Predictor in Febrile Seizures, A Diagnostic Comparative Study

Dr. Aswin L | Dr. Thumjaa A | Dr. SriLakshmi | Dr. Mathivanan

Abstract: Background: The prevalence of febrile seizures was reported to be 3.28?5.71/1000 in South India and 2.27 per 1000 people from Uttarakhand. Febrile seizure affects 2 - 14% of all children globally. Up to 10% of simple febrile seizures were reported during a home - based survey in a state of South India. According to data from the United States, there are half a million of febrile seizure episodes every year. Neutrophil lymphocyte ratio has been proposed as a practical predictor of seizure among febrile children. We conducted this study to predict the usefulness of NLR in febrile children who are at risk for developing seizures and the types of febrile seizures. Material & Method: A comparative cross - sectional study was conducted among children of age group 6 months to 5 years admitted in paediatric department, AVMC. After obtaining informed consent from parents/ guardians, 198 children fulfilling inclusion criteria were enrolled in this study. Among 198 children, 99 children belonged to case group (i. e) febrile seizure and 99 children belong to control group (i. e) fever without seizure. Venous blood sample was collected and sent for complete blood analysis. NLR was calculated by dividing absolute neutrophil count and absolute lymphocyte count and the value was recorded. NLR values in both groups were determined. All the analysis was done using Statistical Package for Social Sciences software (SPSS) version 28. Result: The mean age difference in case group was 1.75?1.04 whereas in control group was 3.48?1.72 and it is statistically significant with P value <0.001. Among 198 children, 99 children were with febrile seizure, in which 67.7% were diagnosed to have simple febrile seizure and 32.3% children had complex febrile seizure. The mean neutrophil lymphocyte ratio for children with febrile seizure was 3.39?1.68 compared to 1.88?1.67 for children with fever without seizure (P value <0.001). Mean NLR in simple febrile seizure is 3.21?1.39 and complex febrile seizure is 3.77?2.15 which is not statistically significant. ROC analysis for case group and control group showed that if the chosen cutoff value for NLR is 2.35, the sensitivity and specificity are 74.7% and 72.7%, respectively (p = 0.001, AUC 0.770, CI 0.702 - 0.838). ROC analysis for SFS and CFS showed that if the chosen cutoff value for NLR is 3.16, the sensitivity and specificity are 68.8% and 49.3%, respectively (p = 0.17, AUC 0.58, CI 0.455 - 0.713). Conclusion: This study shows the mean neutrophil lymphocyte ratio for children with febrile seizure was higher than the mean NLR for children with fever without seizure. The mean NLR in complex febrile seizure is higher than simple febrile seizure but not statistically significant. Hence NLR is proved to be a reliable indicator to predict the occurrence of seizure in febrile children.

Keywords: Neutrophil Lymphocyte Ratio, Simple febrile seizure, Complex febrile seizure

Edition: Volume 12 Issue 2, February 2023,

Pages: 307 - 311

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