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Case reports of hyponatremic seizures in infants have typically revealed that the child took solute-poor fluids or excessively diluted formula. This retrospective case series sought predictors of hyponatremia in infants with first-time seizures and assessed the benefit of a 3 percent saline bolus.
Fifty-six consecutive infants under 1 year old with a first-time seizure were evaluated over a 42-month period. Twenty-seven percent were hyponatremic (i.e., serum sodium below 128 mmol/l); these infants were significantly younger than those with nonhyponatremic seizures and had significantly lower body temperatures, higher serum glucose concentrations, and lower serum bicarbonate concentrations. All had been formula-fed, and 87 percent had receive…