轮状病毒肠炎伴良性婴幼儿惊厥22例临床分析

目的：探讨轮状病毒（rotavirus,RV）肠炎伴良性婴幼儿惊厥的临床特点,并评价其预后。方法：回顾性分析2008年6月至2012年10月门诊及住院的RV肠炎伴良性婴幼儿惊厥患儿的临床表现、实验室检查和治疗效果并进行随访。结果：22例患儿中男14例,女8例,发病年龄6~23个月,高发年龄12~18个月,占40.90%。所有患儿均表现为全身强直–阵挛性发作,缓解后神志恢复迅速,无进行性意识障碍。所有病例均在病程72 h内发生惊厥,发作1次20例,发作2次2例,持续时间均小于5 min,对症治疗后迅速缓解。发作间期2例患儿脑电图轻度异常,表现为背景电活动变慢,均未见痫样波发放,恢复期转为正常。所有患儿头颅CT或头颅MRI,血电解质、血糖及脑脊液检查均正常。惊厥停止后未予抗癫痫治疗。随访2~18个月,1例有热性惊厥史患儿再次出现热性惊厥,其余21例患儿预后良好,患儿精神运动发育均正常。结论：RV肠炎病程初期可能伴发无热惊厥,12~18个月年龄高发,惊厥易控制,无需长期抗癫痫治疗,预后良好,未出现复发病例。

Clinical Analysis of 22 Patients with Rotavirus Enteritis Associated with Benign Infantile Convulsions

Objective： To investigate the clinical features of rotavirus（ RV） enteritis associated with benign infantile convulsions,and to evaluate its prognosis. Methods： A retrospective analysis of clinical manifestations,laboratory tests and treatment effect and follow-up from Jun 2008 to Oct 2012 in hospital outpatient and inpatient patients with RV enteritis associated with benign infantile convulsions was done. Results： In 22 patients,there were 14 males and 8 females,6 to 23 months of age at onset,high incidence of age 12 to 18 months accounted for 40. 90%. All cases showed generalized tonic-clonic seizures,consciousness after remission recovered rapidly with non-progressive disturbance of consciousness. Seizures of all cases occured in the course of 72 h,attack 1 occurred in 20 cases,attack 2 occurred in 2 cases,and the duration was less than 5 min. After treatment,symptom was quickly relieved.EEG showed mildly abnormal interictal performance as background electrical activity slows down in 2 cases with no epileptiform waves payment. Head CT or MRI,serum electrolytes,glucose,and cerebrospinal fluid examination were normal. Antiepileptic therapy after cessation of seizures was not given. One patient with a history of febrile seizures showed febrile seizure after follow-up 2 to 18months. Psychomotor development was normal in all cases. Conclusions： Renteritis in early course may be associated with non-thermal convulsions,high incidence of age 12 to 18 months,convulsion is easy to control without the need for long-term antiepileptic treatment,the prognosis is good and without recurrence.