Hyperpolarization and short-circuiting as mechanisms of seizure prevention following febrile convulsions.
Though children with febrile convulsions only have seizures in the early stage of a febrile illness and not later, these seizures have been attributed to the fever. We studied the serum electrolyte and metabolite profiles in the later stage to see if there were fuel responses resulting in electrophysiological changes which prevented further seizure activity. On admission there was intracellular glucose starvation, as evidenced by increased ketones and lactate, and the possibility of the failure of some electrolyte pumps, as suggested by hyperuricaemia (energy crisis) and decreased serum Na+, Cl- and Ca2+. However, there was adaptive hyperglycemia and decreased serum K+. It seems likely that the hyperglycemia, induced the uptake of K+ by neurones, enabling their repolarization and hyperpolarization, which prevented further seizure activity, while Cl- influx short-circuited depolarizing currents produced by Na+ influx. Studies during recovery showed a gradual return of the metabolic and electrolyte aberrations to normality, suggesting that the provision of energy through adaptation to the stress, enabled recovery of the aforementioned pumps.
Department of Paediatrics, National University Hospital, Kent Ridge, Singapore.
E J
EJ
Aiyathurai
P S
PS
Low
E
E
Jacob
D001786:Blood Glucose / Q000378:metabolism; D002118:Calcium / Q000097:blood; D002540:Cerebral Cortex / Q000503:physiopathology; D002675:Child, Preschool; D002712:Chlorides / Q000097:blood; D004569:Electroencephalography; D004573:Electrolytes / Q000097:blood*; D004734:Energy Metabolism; D005071:Evoked Potentials; D005260:Female; D006801:Humans; D007223:Infant; D007657:Ketone Bodies / Q000097:blood; D007773:Lactates / Q000097:blood; D019344:Lactic Acid; D008297:Male; D010710:Phosphates / Q000097:blood; D011188:Potassium / Q000097:blood; D003294:Seizures, Febrile / Q000503:physiopathology*; D012964:Sodium / Q000097:blood; D014527:Uric Acid / Q000097:blood
D001786:Blood Glucose; D002712:Chlorides; D004573:Electrolytes; D007657:Ketone Bodies; D007773:Lactates; D010710:Phosphates; D014527:Uric Acid; D019344:Lactic Acid; D012964:Sodium; D011188:Potassium; D002118:Calcium