The best questions often stem from the inquisitive learner. As educators, we love, and are always humbled, by those moments when we get to say, “I don’t know.” For some of these questions, you may already know the answers. For others, you may have never thought to ask the question. For all, questions, comments, concerns, and critiques are encouraged. Welcome to the Kids Korner.

Anecdotally, every time it rains, it seems like there are more pediatric seizures. Is this true? Is there an association between seizures in kiddos and falling barometric pressures? Maybe it’s just our own recall bias? While it is unlikely to clinically change your practice, it may change your differential diagnosis on a rainy day.

Some of the earliest investigations on this topic started back in the mid-1960s when Boldrey and Millichap explored the relationship between seizure and atmospheric pressure in mice.¹ Interestingly, there is very little further exploration on this topic until the mid-to-late 2010s when there was renewed discussion on climate and climate change. Since then, a number of additional studies have looked at the association between weather and seizure. While there are some studies that include only adults, we’re focusing on pediatric studies.

A retrospective study by Kim, et al., evaluated 11 years of emergency department (ED) visits in Changwon, South Korea, and their relationship to weather.² The authors retrieved weather data from a government website and looked at daily mean temperature, diurnal temperature range (difference between maximum and minimum temperature on a single day), humidity, atmospheric pressure, cloud cover, wind speed, and sunshine. The authors then looked at the association of total ED visits and visits for seizures, as well as the characteristics of these seizures.

During this 11-year period, there were 108,628 pediatric ED visits with 3,484 seizures (3.2 percent). First-time seizures accounted for 74 percent of the total seizures; the seizure types included first-time afebrile seizures, breakthrough seizures in known epileptic patients, febrile seizures, and status epilepticus. Overall, mean temperature was the only significant factor associated with seizures, and febrile seizure was the only type of seizure associated with mean temperature.

In brief, lower mean temperature was significantly associated with more febrile seizures. But it’s important to note, though, that this is just an association and not necessarily a direct causation. Humidity, atmospheric pressure, sunshine, and diurnal temperature range were not statistically significant.

Unlike the prior study, a retrospective eight-year study at a single pediatric ED in Japan found no association between weather and febrile seizures (Kawakami, 2021).³ The authors evaluated ambient temperature, atmospheric pressure, relative air humidity, rainfall amount, sunshine duration, and air concentrations of NO2 and SO2. The authors analyzed 560 children who had febrile seizures and noted that the presence of epidemic influenza and infectious gastroenteritis — but not the weather — were associated with febrile seizures.