Purpose Hydrocephalus is a complex pediatric neurologic disorder characterized by abnormal cerebrospinal fluid (CSF) flow and ventricular dilation. It poses significant challenges in clinical management and often leads to severe morbidities despite treatment. This study explores the correlation between pre-shunt seizures in hydrocephalic children and inflammatory mediators and electrolyte imbalances in the CSF. Methods An analytical correlational study design was employed, utilizing a comprehensive array of clinical data, radiological databases, and cerebrospinal fluid (CSF) samples obtained from pediatric patients at seven neurosurgical centers. The study population consisted of children with hydrocephalus, both with and without a history of seizures. Sample selection followed strict inclusion and exclusion criteria. Laboratory examinations included a comprehensive CSF analysis for Na + , K + , Ca 2+ , Mg 2+ , IL-1β, IL-6, and TNF-α levels. Hydrocephalus imaging was based on established radiographic criteria, with particular focus on periventricular hypodensity. The analytical process explored the associations between inflammatory markers, electrolyte imbalances, periventricular hypodensity, and the occurrence of seizures. Result While most electrolytes showed no association with seizure activity, Mg2+ levels stood out as a notable exception. Specifically, higher Mg2+ levels were significantly correlated with seizure incidence, with a mean of 1.8 mEq/L (SD ± 0.4) and a p-value of 0.03. A significant difference in Ca2+ levels was also observed between hydrocephalus patients with marked periventricular hypodensity in the seizure and non-seizure groups. This finding was interesting because most studies have reported that hydrocephalic children with lower, not higher, electrolyte levels are more prone to seizures. Conclusion This study reveals significant associations between some electrolytes and seizure activity in pediatric hydrocephalus. Notably, Mg2+ levels were correlated with seizure incidence, suggesting a key role in seizure pathophysiology. Additionally, the observed differences in Ca2+ levels, particularly in patients with periventricular hypodensity, point to a potential connection between Ca2+ dysregulation, brain tissue alterations, and seizure susceptibility.
Sobana et al. (Wed,) studied this question.