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Clinical Features of Benign Infantile Convulsions with Gastroenteritis

Korean Journal of Pediatrics 2005;48(7):753-759.
Published online July 15, 2005.
Clinical Features of Benign Infantile Convulsions with Gastroenteritis
Jung Sun Lee1, Hae Oak Kwon1, Young Mee Jee2, Kyu Young Chae1
1Department of Pediatrics, College of Medicine, Pochon CHA University, Sungnam, Korea
2Division of Enteric and Hepatitis Viruses, National Institute of Health, Korea
위장관염과 동반된 양성 영아 경련의 임상적 고찰
이정선1, 권혜옥1, 지영미2, 채규영1
1포천중문의과대학교 소아과학교실
2국립보건원 바이러스질환부 소화기바이러스과
Correspondence: 
Kyu Young Chae, Email: barnabas@cha.ac.kr
Abstract
Purpose
: This study was performed to characterize clinical features of benign convulsions with gastroenteritis(CwG) in infants.
Methods
: We reviewed clinical features of 67 episodes in 64 patients with afebrile seizure accompanied gastroenteritis admitted to Dept. of Pediatrics Bundang CHA hospital from January 2001 to June 2004. Patients with meningitis, encephalitis/encephalopathy or apparent history of epilepsy were excluded.
Results
: There were 32 boys and 35 girls. The age of onset ranged from 1 to 42 months(18.5?.1 months). The number of children admitted to the hospital with acute gastroenteritis was 2,887 in the same period. The percentage of patients with CwG was 2.3. Seizure type was exclusively generalized tonic or tonic-clonic seizure. The average number of seizures during a single episode was 3.1 (range, 1-13). Two or more seizures occurred in 53(79.1%) of the 67 episodes. Antiepileptic drugs were administered for 42 episodes. Seizure did not cease after the administration of one kind of antiepileptic drug in 23 episodes(54.7%). The seizures were rather refractory to initial antiepileptic treatment. There were no abnormalities in serum biochemistry test including glucose and electrolytes. Cerebrospinal fluid was normal in all 54 episodes. Stool cultures were negative in 49 episodes. Rotavirus was positive in stools in 51(82.3%) of 62 episodes. Norovirus was positive in stools in 2 episodes and astrovirus in 1 of 18 episodes. CT and/or MRI were performed in 15 cases and demonstrated no neuroradiologic abnormalities. Of 73 Interictal EEG, initial 24 cases showed occasional spike or sharp wave discharges from the mid-line area during stage I-II sleep, which were apparently differentiated from vertex sharp transient or K-complexes. The mean follow-up period was 5.7 months(1-36 months). Three patients experienced a recurrence of CwG, but all patients exhibited normal psychomotor development at the last follow-up.
Conclusion
: Afebrile infantile convulsions with gastroenteritis are brief generalized seizure in cluster with normal laboratory findings and good prognosis. Therefore CwG is likely to be categorized as situation-related seizure of special syndrome. Recognition of this entity should lead to assurance of the parents and long-term anticonvulsant therapy is not usually warranted.
Key Words: Afebrile infantile convulsion , Gastroenteritis , Situation-related seizure


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