轻度胃肠炎伴婴幼儿良性惊厥111例临床分析及远期随访研究

目的 研究轻度胃肠炎伴婴幼儿良性惊厥(BICE)临床特点及其远期预后。 方法 选择2013年7月-2015年7月于郑州大学第三附属医院收治的111例BICE患儿,按惊厥发生次数分为单发组56例(惊厥1次),多发组55例(惊厥次数 ≥ 2次);根据惊厥持续时间分为2组:惊厥持续时间<5 min者为短时组,共81例,惊厥持续时间 ≥ 5 min者为长时组,共30例。总结、分析其临床、实验室检查、影像学及电生理辅助检查资料,并对所有患儿随访观察2年,分析预后。 结果 BICE患儿年龄集中在13~24个月,占全部患儿56.8%;一年四季均有发病,秋冬季节为主;82例3 d内发生惊厥,占73.9%;全面性起源的强直阵挛发作99例(89.2%),局灶性进展为双侧强直阵挛性发作12例(10.8%);62例(55.9%)大便轮状病毒抗体检测阳性;单发组与多发组、短时组与长时组在性别、年龄、轮状病毒阳性率方面差异均无统计学意义(均P>0.05)。血液、脑脊液常规、生化及培养检查、头颅影像学检查等均正常;发作间期脑电图检查结果显示,11例见睡眠纺锤波及慢波改变,4例中央区顶部不典型尖慢波或棘慢波,余均正常。2年随访结果显示,9例(8.1%)患儿复发,6例转化为癫痫(5.4%)。 结论 BICE高发于13~24个月幼儿,一年四季均有发病,秋冬季节多见,多数预后良好,少数病例有向癫痫转化的可能,不需进行长期预防性抗惊厥治疗,长期随访很有必要。 

Benign infantile convulsions with mild gastroenteritis: clinical analysis and long-term follow-up research of 111 cases

Objective To investigate the clinical characteristics and long-term prognosis of benign infantile convulsions associated with mild gastroenteritis (BICE). Methods One hundred and eleven children with BICE in our hospital from July, 2013 to July, 2015 were enrolled. According to the frequency of convulsions, the patients were divided into single group (n=56, convulsion once), and multiple group(n=55, convulsions ≥ 2 times). According to convulsion duration, the patients were divided into short-term group (n=81, convulsions duration <5 minutes), and long-term group (n=30, convulsion duration ≥ 5 minutes). The clinical data obtained during hospitalization and follow-up were analyzed. Results The retrospective analysis showed that the onset age ranged from 13 months to 24 months accounted for 56.7% in all children. It occured at all seasons of the year, the highest incidence was in autumn/winter, The seizure of 82 cases occurred in the first 3 day, 73.9% of all children. The seizures were generalized in 99 cases(89.2%), focal and secondarily generalized in 12 cases(10.8%). Sixty-two cases (55.9%) fecal rotavirus antigen positive. The differences of sex, age of onset, positive rate of stool rotavirus between single group and multiple group, between short-term group and long-term group with BICE were not statistically significant (P>0.05). Blood biochemical examination, cerebrospinal fluid routine, biochemical and culture tests, brain imaging were all normal. Interictal monitoring as EEG, 11 cases changed in sleep spindles and slow wave, 4 cases appeared sharp slow wave or spike slow wave at central top area, the other cases were normal. Two years follow-up research showed that 9 cases (8.1%)were relapsed and 6 cases (6.15%) developed epilepsy. Conclusion The 13 months-24 months old children have high incidence of BICE, and it occured at all seasons of the year, the highest incidence is in autumn/winter. Prognosis is good for most of the cases, a few cases may develop into epilepsy, long-term prophylaxis of antiepileptic treatments is not necessary, it is very necessary to followed up for a long time.