轻度胃肠炎伴婴幼儿良性惊厥38例临床分析

目的:研究轻度胃肠炎伴婴幼儿良性惊厥的病因、临床特征、治疗、预后,以提高对该病的认识和诊断、治疗水平。方法:对我院2008年至2010年收治的38例轻度胃肠炎伴婴幼儿良性惊厥患儿的临床表现、实验室检查、治疗结果及随访结果进行回顾性分析。结果:38例患儿胃肠道症状相对较轻,无或有轻度脱水,电解质基本正常,脑脊液检查正常,头颅影像学正常。年龄2-36个月,平均15.6 8.2月,惊厥发生于第1天10例(26.3%),第2天16例(42.1%),第3天6例(15.8%),第4天2例(5.3%),第5天2例(5.3%),第6天1例(2.6%),第7天1例(2.6%)。惊厥发作次数1-5次,仅发作1次25例(65.7%),发作2次7例(18.4%),发作3次3例(7.8%),发作4次2例(5.3%),发作5次1例(2.6%)。35例惊厥表现为全身性强直-阵挛发作(92%),3例有失神及局灶性发作(8%)。4例患儿发病后脑电图检查异常,经复查均恢复正常。随访38例患儿均无复发,生长发育正常。结论:轻度胃肠炎伴婴幼儿良性惊厥病因尚不十分清楚,消化道症状轻而惊厥可反复发作,发作间期精神状态较好,苯巴比妥钠仍是治疗的有效药物,首剂给药剂量10mg/kg。本病预后良好,无复发,不遗留神经系统后遗症。

Benign Infantile Convulsions with Mild Gastroenteritis:Clinical Study of 38 Patients

Objective: To analyze the etiology,clinical characteristics,treatment and prognosis in patients of benign infantile convulsions with mild gastroenteritis(BICE).To improve the congnition,diagnosis and treatment standard of the disease.Method: Evaluated the clinical manifestations,laboratory findings,treatment outcome and follow-up results of 38 patients who were assessed in our hospital.Result: All of the 38 children had mild gastroenteritis with or without minor dehydration,electrolytes were normal,CSF examination were normal,with normal head imaging.The children were aged 2 to 36 months (15.6±8.2)months].Convulsions occurred in 10 patients(26.3%) on the first day;The number of seizures ranged from 1 to 5 per child;Convulsions did not recur in 25 children(65.7%).35 children had generalised seizures and 3 had absence and focal seizures.The interictal EEG was abnormal in 4 patients.After 6 and 24 months of follow-up,38 children had no seizures and neurological sequelae.Conclusion: The mechanism underlying convulsions is not clear.The digestive system manifestations are mild and seizures can be recurrent.Mental state is good during convulsion.Phenobarbital sodium is still effective drug treatment,the first dose is 10mg/kg.Most of children with BICE have a good prognosis,without recurring and central nervous system’s sequelae.