The role of neutrophil-lymphocyte ratio and red blood cell distribution width in the classification of febrile seizures.

Objective: Most febrile seizures occur outside of hospitals, and in most cases, information about the characteristics of the seizures is obtained from the parents. This makes it difficult to differentiate between simple and complex seizures. The aim of this study is to evaluate the significance of the Neutrophil-Lymphocyte Ratio (NLR) and the red blood cell (erythrocyte) distribution width (RDW) in distinguishing between simple and complex febrile seizures.

Patients And Methods: The files of 142 patients between the ages of 6 months and 5 years who were admitted to the Emergency Department with the diagnosis of first febrile seizure were reviewed retrospectively. Complete blood count and C-reactive protein (CRP) parameters obtained from the venous blood samples collected from the patients at admission were evaluated.

Results: The average values of NLR for simple and complex seizure groups were 2.38 ± 1.60 and 3.42 ± 1.77 respectively, and the difference was statistically significant (p < 0.001). The average values of RDW for simple and complex seizure groups were 16.15 ± 1.37 and 16.27 ± 1.53, respectively; the difference was not significant (p = 0.631). We used receiver operating characteristic (ROC) analysis and chose a cutoff value of 2.315 for the NLR, and we found that the sensitivity and specificity were 62.7% and 53.8%, respectively (area under the curve [AUC]: 0.665, p = 0.001, confidence interval [CI] 0.573-0.756).

Conclusions: We suggest that NLR may provide clinicians with an insight into differentiating between simple and complex febrile seizures; however, it does not produce a clear-cut distinction. We found that the RDW ratio is not useful in this differentiation.