Abstract
            Background: Vitamin B12 (VB12) is a water-soluble vitamin, deficiency of which causes an  extensive heterogeneous spectrum of neurological symptoms including vision disturbances,  paresthesia, tremor, and seizure. The aim of this investigation is to determine the effect of serum  VB12 levels on pediatric patients with febrile seizure (FS).  
  Methods: In this meta-analysis, case-control studies that evaluated the effect of serum VB12  levels in pediatric patients with FS were included. Web of Science, PubMed, Scopus, and Google  Scholar were searched until August 13, 2024. The PICO criteria for this meta-analysis were as follows: Population/Patients (P: pediatric patients with febrile seizures); Issue of interest (I: serum  levels of VB12); Comparison (C: control); Outcome (O: occurrence of febrile seizure). Quality  assessment was assessed according to the Newcastle-Ottawa Scale (NOS) tool for case-control  studies. The outcome assessment scales, study groups, and serum VB12 levels were extracted.  
  Results: Of 435 initial articles, eventually 6 studies remained in the meta-analysis. Existing  evidence indicated that serum VB12 concentrations were insignificantly lower in FS patients  than controls (WMD= -1.09 pg/ml; 95% CI: -2.23, 0.04; P= 0.06), although a significant between-study heterogeneity was observed (I2  = 98.10%, P< 0.001).  
  Conclusion: The results of our study pointed out that there is low serum VB12 concentrations  in FS patients compared with controls. Despite the fact, one of the best ways to prevent FS in  children can be VB12 supplementation and proper diet therapy.