轻度胃肠炎伴良性婴幼儿惊厥的临床治疗体会

目的了解轻度胃肠炎伴良性婴幼儿惊厥(BICE)的病因、临床特点及预后。方法 2009-06—2014-06在我院儿科住院的31例符合BIEC患儿进行病史采集,临床观察和出院后6~9个月随访。结果 31例患儿发病平均年龄19个月,秋冬季多见。83.8%患儿出现胃肠炎48h内发生惊厥,为全身性发作,发作≥2次者21例,每次持续1~3min。发作间期脑电图、头颅影像学正常,血生化、脑脊液正常。轮状病毒感染阳性率达64.51%(20例),提示BICE与轮状病毒感染密切相关。4例短期应用抗癫痫药外,其他在癫痫停止后未再应用抗癫痫药。随访21例,患儿无复发,智力运动发育正常。结论BICE多发生在秋冬季胃肠炎的早期,复发反复出现全身性发作无热惊厥,预后良好,一般无需长期服用抗癫痫药。     

轻度胃肠炎伴良性惊厥患儿血钠离子浓度分析

目的研究轻度胃肠炎伴婴幼儿良性惊厥患儿的血钠水平。方法以我院2008-2011年诊断的轻度胃肠炎伴婴幼儿良性惊厥23例患儿为观察组,以同期患有轻度胃肠炎而不伴有惊厥的25例患儿为对照组,统计学分析2组患儿急性期血钠水平测定结果。结果观察组血钠离子浓度(137.3±13.1)mmol/L,对照组血钠离子浓度(145.1±10.8)mmol/L,2组比较差异有统计学意义(P<0.05)。结论轻度胃肠炎伴婴幼儿良性惊厥患儿的惊厥发作可能与患儿血液内钠浓度降低有关。     

轮状病毒感染与轻度胃肠炎并良性婴幼儿惊厥的相关性历史队列研究

目的 研究轮状病毒(RV)感染与轻度胃肠炎并良性婴幼儿惊厥的相关性.方法 将我院既往3年内收住院的轮状病毒肠炎(大便轮状病毒抗原阳性)321例设为暴露组,而非轮状病毒肠炎(大便轮状病毒抗原阴性)350例为非暴露组.观察胃肠炎症状后1周时间,统计发生惊厥的病例数,计算相对危险度(RR值)及95%可信区间并进行统计学分析.结果 暴露组中37例出现惊厥,发生率为11.53%;而非暴露组11例发生惊厥,发生率为3.14%,RR= 3.67,95%可信区间为2.0 ～ 6.72 ,χ2=17.71,P＜0.01.结论 轮状病毒感染与轻度胃肠炎并良性婴幼儿惊厥之间存在相关性.     

探讨轮状病毒感染与良性婴幼儿惊厥的相关性

目的探讨轮状病毒感染与良性婴幼儿惊厥的相关性。方法选取轻度胃肠炎患儿50例,根据是否感染轮状病毒,分为观察组和对照组,同时进行实验室检查,比较轮状病毒感染与轻度胃肠炎并良性婴幼儿惊厥相关性。结果 2组患儿的血尿常规检查均正常,惊厥发作期脑电图异常,大便常规明显差异。观察组惊厥发生率为36.4%,对照组为10.7%,组间差异有统计学意义(P0.05)。结论轮状病毒感染与轻度胃肠炎并良性婴幼儿惊厥之间存在一定的相关性,应加以重视。     

轮状病毒肠炎伴良性婴幼儿惊厥23例临床分析

目的分析轮状病毒肠炎伴良性婴幼儿惊厥的临床特点。方法对我院收治的23例轮状病毒肠炎伴惊厥患儿进行临床观察和随访。结果23例患儿发病年龄(13．8±6．4)个月,3 d内发生惊厥者19例,均为全身性发作,持续时间短,不超过5 min,一次病程中平均发作次数1．7次。多数病例不复发,部分可复发,病程＜1年。惊厥停止后未行抗癫痫治疗。发作间期脑电图正常,血生化、脑脊液、脑CT等检查正常。全部病例无癫痫和热性惊厥家族史,精神运动发育正常。结论本组病例具有以下特点：(1)1～2岁高发,冬春季多见,婴幼儿既往体健,无家族史；(2)惊厥于病程1～5 d发作,1～3 d多见,惊厥多发生于玩耍过程中,全身性发作为主,无脱水及酸中毒；(3)血生化、脑脊液、脑CT和发作间期脑电图均正常；(4)多数病例不复发,部分可复发,病程＜1年,预后好。     

婴幼儿腹泻伴良性惊厥56例临床治疗体会

目的通过对56例婴幼儿腹泻伴良性惊厥临床诊断与治疗的分析,总结、提高对该病的认识,从而提高对该病的治愈率。方法通过对56例婴幼儿腹泻伴良性惊厥的发病病因了解、临床表现及影像学、实验室检查对该病有进一步的认识。结果该组患儿愈后良好,无反复及癫痫出现。结论婴幼儿腹泻伴良性惊厥是儿科常见疾病,通过对该病的认识有助于早期对患儿的明确诊断及合理治疗,可减少不必要的检查和复杂的治疗。     

小儿反复性高热惊厥临床分析

高热惊厥（简称FC）是小儿常见急诊之一，可由多种疾病引起，临床以单纯性高热惊厥多见，复杂性商热惊厥次之。我院自1990年2月至1997年8月门诊及病房诊治的53例高热惊厥患儿，经门2年一5年随访并进行了回顾性分析，以便于指导临床，现报告如下：1；临床资料对例男32例，女ZI例。年龄6个月一6岁，其中6个月一2岁叨树（刀％），2岁一6岁月例（43％）。诊断标准参照1983年全国小儿神经学术会议专题讨论会“关于高热惊厥诊断和治疗的建议。”FC诱因：上感38例，肺炎6例、幼儿急诊3例、肠道感染4例、腮腺炎2冽。有癫病及区家族史问例（刀％）…     

婴幼儿良性惊厥32例临床分析及血清神经元特异性烯醇化酶测定

目的研究轻度胃肠炎并婴幼儿良性惊厥的临床特点及中枢神经元的损伤情况。方法收集2008-11～2010-01我院诊断轻度胃肠炎并婴幼儿良性惊厥的32例患儿作为观察组,记录患儿的胃肠炎表现及惊厥特点,随访6月以上。应用Elecsys 2010电化学发光免疫分析仪检测血清NSE水平。对照组20例,为同期我院门诊健康体检者。结果患儿胃肠炎均较轻,仅11例伴有轻度脱水,无电解质紊乱,大多惊厥频繁可成簇发作,最多者惊厥达5次,发作形式多为强直或强直阵挛,仅6例伴双目向一侧斜视。发作间期脑电图多正常,有7例见散在癫样放电,影像学检查均未见异常。该病预后良好,31例随访期间未再出现惊厥,仅1例因再次轻度胃肠炎并婴幼儿良性惊厥出现惊厥复发。观察组NSE高于正常对照组(P<0.01)。结论轻度胃肠炎并婴幼儿良性惊厥胃肠炎表现均轻微,惊厥往往成簇发作;发作间期脑电图多正常;可对神经元造成损伤;预后良好。     

Clinical features of benign convulsions with mild gastroenteritis

The aim of this study is to reveal the detailed clinical features of benign convulsions with mild gastroenteritis (CwG).

We studied 114 consecutive episodes in 105 patients with CwG between January 1995 and March 2000. CwG was defined as when a patient met the following two conditions: (a) seizures accompanied the symptoms of gastroenteritis without clinical signs of dehydration or electrolyte derangement and (b) the body temperature remained less than 38.0°C before and after the seizures. Patients with meningitis, encephalitis/encephalopathy or apparent history of epilepsy were excluded.

The age of onset ranged from 8 to 52 months (mean, 21.1±8.4 months). Six patients (6%) had a family history of afebrile convulsions and seven (7%) had one of febrile convulsions. The average interval between the onset of gastroenteritis and that of seizures was 2.3±1.1 days (range, 1–6 days). The average number of seizures during a single episode was 2.6±1.5 (range, 1–7). Two or more seizures occurred in 86 (75%) of the 114 episodes. Seizures induced by pain and/or crying were seen in 35 (43%) of 82 episodes. Antiepileptic drugs were administered for 96 episodes. Seizures did not cease after the administration of one kind of antiepileptic drug in 56 episodes (58%). Epilepsy developed in none of the patients. All patients exhibited normal psychomotor development.

CwG is characterized by a cluster of seizures that are sometimes induced by pain and/or crying. The seizures are rather refractory to antiepileptic treatment, although the seizure and development outcomes are good.     

Incidence and characteristics of norovirus-associated benign convulsions with mild gastroenteritis,in comparison with rotavirus ones

Background and purpose

Rotavirus was detected in 40–50% of patients with benign convulsions with mild gastroenteritis (CwG) before the rotavirus vaccine was introduced in late 2000. However, the rate of rotavirus positivity has decreased since 2010 while the prevalence of norovirus has gradually increased. We investigated the incidence of norovirus-associated CwG during a recent 3-year period and additionally compared the characteristics of norovirus-associated CwG with those of rotavirus-associated CwG.

Efficacy of phenobarbital for benign convulsions with mild gastroenteritis: A randomized,placebo-controlled trial

ObjectiveThis study was performed to evaluate the efficacy and safety of intravenous phenobarbital (PB) for benign convulsions with mild gastroenteritis (CwG).MethodsA randomized, single-blind, placebo-controlled trial involving patients with CwG was conducted at the Japanese Red Cross Society Himeji Hospital. Patients with CwG who had experienced two or more seizures were eligible. Patients were excluded if any anticonvulsant was used before enrollment. Patients who were allocated to the PB group were administered 10 mg/kg of PB intravenously. Patients who were allocated to the placebo group were administered 20 ml of normal saline.ResultsFrom April 2016 to October 2018, 13 of 24 patients with CwG were randomized (PB group, n = 7; placebo group, n = 6; age, 1–3 years). Five of six patients in the placebo group had seizures after administration of placebo. However, patients in the PB group had no seizures after administration of PB, with a significant difference in efficacy between the two groups (P = 0.005). Five patients who had seizures after administration of normal saline were administered 10 mg/kg of PB, and no patients had a seizure thereafter. No significant differences were found in heart rate, blood pressure, or saturation of percutaneous oxygen between the two groups.ConclusionThis is the first randomized controlled trial to evaluate the efficacy of an anticonvulsant for CwG. Intravenous PB at 10 mg/kg is effective and well tolerated for CwG.     

Genetic analysis of PRRT2 for benign infantile epilepsy,infantile convulsions with choreoathetosis syndrome,and benign convulsions with mild gastroenteritis

Purpose: PRRT2 mutations were recently identified in benign familial infantile epilepsy (BFIE) and infantile convulsions with paroxysmal choreoathetosis (ICCA) but no abnormalities have so far been identified in their phenotypically similar seizure disorder of benign convulsions with mild gastroenteritis (CwG), while mutations in KCNQ2 and KCNQ3 have been recognized in benign familial neonatal epilepsy (BFNE). The aim of this study was to identify PRRT2 mutations in infantile convulsions in Asian families with BFIE and ICCA, CwG and BFNE. Methods: We recruited 26 unrelated Japanese affected with either BFIE or non-familial benign infantile seizures and their families, including three families with ICCA. A total of 17 Japanese and Taiwanese with CwG, 50 Japanese with BFNE and 96 healthy volunteers were also recruited. Mutations of PRRT2 were sought using direct sequencing. Results: Heterozygous truncation mutation (c.649dupC) was identified in 15 of 26 individuals with benign infantile epilepsy (52.1%). All three families of ICCA harbored the same mutation (100%). Another novel mutation (c.1012+2dupT) was found in the proband of a family with BFIE. However, no PRRT2 mutation was found in either CwG or BFNE. Conclusions: The results confirm that c.649dupC, a truncating mutation of PRRT2, is a hotspot mutation resulting in BFIE or ICCA regardless of the ethnic background. In contrast, PRRT2 mutations do not seem to be associated with CwG or BFNE. Screening for PRRT2 mutation might be useful in early-stage differentiation of BFIE from CwG.     

Single-dose chloral hydrate for benign convulsions with mild gastroenteritis

PURPOSE: To reveal the efficacy of single-dose treatment with chloral hydrate (CH) for clustering seizures in benign convulsions with mild gastroenteritis. METHODS: We retrospectively studied the details of treatment in 33 patients with ages ranging from 7 to 39 months. The time-series records of seizures and processes of drug administrations were investigated. RESULTS: A single-dose therapy with CH was effective in 19 of 22 patients (86%), and diazepam in two of 16 (13%). The doses of CH in patients having a successful treatment with single-dose therapy ranged from 41.7 to 62.5 mg/kg (mean 50.2). In two patients, seizures were resistant to single-dose CH therapy, and their doses of CH were 33.8 and 35.1 mg/kg. CONCLUSIONS: An advantage of the single-dose therapy with CH was shown. We recommend treatment with a sufficient dose of not less than 40 mg/kg of CH.     

Efficacy of antiepileptic drugs in patients with benign convulsions with mild gastroenteritis

The aim of this study was to clarify the efficacy of antiepileptic drugs during a cluster of seizures in patients with convulsions with mild gastroenteritis (CwG). We retrospectively investigated the details of antiepileptic treatment in 110 consecutive episodes in 103 patients with CwG. The temporal course of the seizures and the use of antiepileptic drugs were investigated in each episode. Drugs were judged as effective when seizure cessation was achieved after administration of the drug. As the first drug, diazepam (DZP)/bromazepam (BZP) was effective in 38%, phenobarbital (PB) in 40%, and lidocaine (LD) in 100%. As the second drug, DZP/BZP was effective in 42%, PB in 69%, and LD in 100%. As the third drug, PB was effective in 70%. When the efficacy of the first doses of PB and LD were compared, the efficacy rate was significantly higher for LD than for PB (P = 0.047). In conclusion, LD was effective for the cessation of seizures in patients with CwG.     

Benign convulsion with mild gastroenteritis and benign familial infantile seizure

The authors present Japanese siblings of a 6-year-old girl and a 4-year-old boy, who concurrently experienced convulsions with mild gastroenteritis. These siblings, their father and paternal grandfather had afebrile seizures that intermittently occurred without symptoms of gastroenteritis and terminated within a few days at their infancy. An underlying genetic factor might not only cause benign familial infantile seizures but it might also confer the susceptibility to the convulsions with mild gastroenteritis in these siblings.     

Benign infantile convulsions associated with mild gastroenteritis: An electroclinical study of 34 patients

PurposeTo analyze the electroclinical features and evolution of patients diagnosed with convulsions with mild gastroenteritis (CwG) from southwest China.MethodsWe reviewed and analyzed the medical records of 34 patients (13 males) diagnosed with CwG and followed-up for at least 12 months.ResultsThe age of onset was 6–29 months and the female/male ratio 1.62. Seizures were generalized in 32 cases. Single seizures in 15 cases were <5 min and multiple seizures 24–48 h after seizure onset were seen in 18 cases. Seizure duration was <1 min in 32.35%, between 1 and 5 min in 55.88%, and between 5 and 10 min in 8.82% of seizures. The average interval between the onset of gastroenteritis and seizures was 2.47 days. Rotavirus antigen was positive in stools in 26.47% of cases. During the acute phase, diazepam and phenobarbital as first-line treatment were effective in 25% and 83.33% of cases, respectively. Fourteen patients showed non-specific anomalies in the interictal electroencephalography. During 12–36 months follow-up, 33 cases showed normal psychomotor development and no seizures.ConclusionsCwG occurred mostly in toddlers. During the acute phase, phenobarbital is more effective in controlling seizures. For a good prognosis, it is unnecessary to administrate long-term anticonvulsants.