Higher admission serum total carbon dioxide is independently associated with early seizure recurrence in children with benign convulsions with mild gastroenteritis - Report - MDSpire

Higher admission serum total carbon dioxide is independently associated with early seizure recurrence in children with benign convulsions with mild gastroenteritis

  • By

  • Ling Zou

  • Feng Li

  • Hongyu Li

  • Zhihong Su

  • June 16, 2026

  • 0 min

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Clinical Report: Elevated Serum Total Carbon Dioxide Levels and Seizure Recurrence

Overview

This study identifies elevated serum total carbon dioxide (TCO2) levels at admission as a significant predictor of early seizure recurrence in pediatric patients with benign convulsions associated with mild gastroenteritis. The findings suggest that TCO2 may serve as a useful biomarker for risk stratification in clinical settings.

Background

Benign convulsions with mild gastroenteritis (CwG) are common in young children and can lead to significant parental anxiety and healthcare resource utilization due to potential seizure recurrence. Identifying reliable biomarkers for early recurrence is crucial for optimizing patient management and improving outcomes. This study explores the association between admission serum TCO2 levels and the likelihood of seizure recurrence within 48 hours.

Data Highlights

MeasureRecurrence GroupNo Recurrence Group
Median TCO2 (mmol/L)17.415.1
Odds Ratio for TCO21.235 (95% CI 1.053–1.448; P = 0.009)
Cutoff TCO2 for Sensitivity16.25 mmol/L
Sensitivity78.3%
Specificity61.9%
Negative Predictive Value88.7%

Key Findings

  • 26.7% of children with CwG experienced seizure recurrence within 48 hours.
  • Higher admission serum TCO2 levels were significantly associated with increased risk of recurrence.
  • The median TCO2 level was 17.4 mmol/L in the recurrence group compared to 15.1 mmol/L in the non-recurrence group (P = 0.007).
  • A TCO2 cutoff of 16.25 mmol/L provided 78.3% sensitivity for predicting recurrence.
  • There was a strong correlation between venous TCO2 and arterial bicarbonate (r = 0.966, P < 0.001).

Clinical Implications

Clinicians should consider measuring serum TCO2 levels in pediatric patients presenting with benign convulsions associated with mild gastroenteritis to assess the risk of early seizure recurrence. This biomarker may aid in decision-making regarding observation and management strategies in the emergency department.

Conclusion

Elevated serum TCO2 levels at admission are linked to an increased risk of early seizure recurrence in children with CwG. Further validation in prospective studies is necessary to confirm these findings and establish TCO2 as a standard biomarker in clinical practice.

Related Resources & Content

  1. Author(s)/Org, Source, Year -- Title
  2. Intensive Care Medicine — Incidence and Outcomes of Seizures in 204 Unconscious Pediatric Patients
  3. Frontiers in Pediatrics — Overreliance on EEG Normalization: A Case Report of DEE-SWAS Treated as Presumed NCSE Leading to Avoidable Escalation
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  5. Frontiers in Pediatrics — Cumulative secondary systemic metabolic cerebral insults are associated with disease severity and mortality in neonatal hypoxic–ischaemic encephalopathy: a retrospective study
  6. Benign convulsions with mild gastroenteritis in children: An emerging acute symptomatic seizures
  7. Laboratory Findings of Benign Convulsions With Mild Gastroenteritis: A Meta-Analysis
  8. Frontiers | Febrile seizures and convulsions with mild gastroenteritis: age-dependent acute symptomatic seizures
  9. Updated classification of epileptic seizures (2025) // International League Against Epilepsy
  10. Clinical characteristics, treatment, and long-term outcomes in children suffering from benign convulsions with mild gastroenteritis: a retrospective study | BMC Pediatrics | Full Text
  11. Changes in frequency of benign convulsions with mild gastroenteritis and their viral causes before and during the COVID-19 pandemic: a single-center study - PubMed
  12. Efficacy of phenobarbital for benign convulsions with mild gastroenteritis: A randomized, placebo-controlled trial - PubMed
  13. Efficacy and safety of phenobarbital for benign convulsions with mild gastroenteritis: A prospective randomized controlled study - PMC
  14. Clinical Characteristics, Treatment, and Outcomes in Children with Benign Convulsions with Mild Gastroenteritis in the Philippine General Hospital: A Retrospective Cohort Study - PMC
  15. Prognostic factors for the recurrence of afebrile seizures after benign convulsions associated with mild gastroenteritis - PubMed
  16. Risk factors for recurrence of benign convulsions with mild gastroenteritis in children: A prospective cohort study - Zaki - 2023 - Journal of Paediatrics and Child Health - Wiley Online Library

Original Source(s)

Higher admission serum total carbon dioxide is independently associated with early seizure recurrence in children with benign convulsions with mild gastroenteritis

  • by Ling Zou, Feng Li, Hongyu Li, Zhihong Su

  • June 16, 2026

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