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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.

A 2021 retrospective study by Yamaguchi, et al., specifically looked at the relationship between new onset nighttime seizures — described as “unprovoked seizures” by the authors — and weather and air pollutants in children younger than 16 years of age in a single pediatric ED in Japan.⁴ So, we are only talking about nighttime seizures.

This was a five-year retrospective study that looked specifically at unprovoked seizures, so febrile seizures were excluded from the study.

Data included atmospheric pressure, precipitation, temperature, relative humidity, wind speed, and hours of sunlight, along with multiple air pollutants such as NO, NO2, SO2, CH4, and particulate matter. There were 98 unprovoked seizures over five years in 151,119 total children. This number of children with unprovoked seizures seems rather small but is consistent with prior data.⁵

In this study by Yamaguchi in children with nighttime unprovoked seizures, the authors noted a positive association between precipitation and unprovoked seizure (one additional patient with seizure per 87 mm precipitation; P=0.03) as well as CH4 and seizure (one additional patient per 0.14 ppm; P=0.048).⁴ While this study demonstrates a positive association between precipitation and new onset unprovoked seizures, it’s rather difficult to apply broadly since unprovoked nighttime seizures are a small subset of all seizure types in children.

Finally, we were able to find one multicenter prospective study that looked at the relationship between weather and seizure. This study by Arai, et al., prospectively followed children over one year with known epilepsy.⁶ Exclusion criteria included children with absence seizures, psychogenic non-epileptiform seizures (PNES), suspected parental neglect, and parents with intellectual disabilities. A seizure diary was used by families, and multiple characteristics/circumstances around the time of the seizure (e.g., sleep deprivation, menstruation, upper respiratory infection symptoms, missed medications) were recorded.

Interestingly, the seizure diary allowed the authors to explore not only seizures that presented to the ED, but seizures that occurred outside the ED in children with known epilepsy. The location of the seizure was documented by the family. Meteorological data preceding the seizure was collected by the authors via the Japan Meteorological Agency website at 6, 12, 24, and 48 hours prior to seizure onset. Data included atmospheric pressure, change in atmospheric pressure, temperature, and relative humidity. A total of 159 seizures in 29 patients were recorded during the observation period. No significant relationship between atmospheric pressure or temperature changes and seizure risk was observed. The study did note an association between humidity and seizure occurrence (OR 1.026; 95% confidence interval (CI) 1.003-1.048; P=0.023), but the effect size was very small.

In the end, there doesn’t appear to be any clear-cut relationship between weather and pediatric seizure at this time.

Summary

Overall, there are not definitive data that suggest that pediatric seizures are extrinsically affected by the weather. Some factors that have been explored include relative humidity, precipitation, temperature, wind speed, and hours of sunlight. No definite relationship between weather and seizures has been consistent across studies.

Dr. Jones is associate professor at the department of emergency medicine & pediatrics and the program director of pediatric emergency medicine fellowship at the University of Kentucky in Lexington, Kentucky.

Dr. Cantor is the emeritus medical director for the Central New York Poison Control Center and professor of emergency medicine and pediatrics in Syracuse, New York.

References

1. Boldrey EE, Millichap JG. Barometric pressure and seizures. Proc Soc Exp Biol Med. 1966. December;123(3):968-70.
2. Kim SH, Kim JS, Jin MH et al. The effects of weather on pediatric seizure: a single-center retrospective study (2005-2015). Sci Total Environ. 2017. December; 609:535-540.
3. Kawakami I, Inoue M, Adachi S et al. The weather condition and epidemics as triggers for febrile seizure: a single-center retrospective observational study. Epilepsy Behav. 2020. October; 111:107306.
4. Yamaguchi H, Nozu K, Ishiko S et al. Multivariate analysis of the impact of weather and air pollution on emergency department visits for unprovided seizure among children: a retrospective clinical observation study. Epilepsy Behav. 2021. December; 125:108434.
5. Dogui M, Jallon P, Ramallah JB et al. Episousse: incidence of newly presenting seizures in children in the region of Sousse, Tunisia. Epilepsy. 2003. November; 44(11):1441-4.
6. Arai Y, Okanishi T, Noma H et al. Meteorological influences on seizure occurrence in children with epilepsy: a case-crossover analysis. Epilepsy Behav. 2025. October; 171:110667.