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Acute gastroenteritis-related encephalopathy
1Department of Paediatrics, The University of Hong Kong, Queen Mary Hospital. vcnwong@hkucc.hku.hk
Insights
Acute gastroenteritis can cause convulsions in children, with Rotavirus infection significantly linked to encephalopathy. Fortunately, these seizures are typically benign and have an excellent prognosis, with no cases developing epilepsy.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Acute gastroenteritis is a common childhood illness.
- Convulsions can occur in children with acute gastroenteritis.
- The association between specific pathogens and neurological complications like encephalopathy requires further investigation.
Purpose of the Study:
- To determine the incidence of convulsions in children with acute gastroenteritis.
- To investigate the association between causative organisms and encephalopathy.
- To assess the prognosis of acute gastroenteritis-related encephalopathy.
Main Methods:
- Retrospective study of 1936 children with acute gastroenteritis.
- Categorization of convulsion causes into bacterial, Rotavirus, and no organism groups.
- Statistical analysis to determine the association between pathogens and encephalopathy, including relative risk calculation.
Main Results:
- 3.5% of children experienced convulsions.
- Rotavirus infection showed a significant association with encephalopathy (P < .002) compared to cases with no organism isolated.
- Relative risk of encephalopathy was higher for Rotavirus vs. no organism (2.308) and Rotavirus vs. bacterial (1.846).
- No children developed epilepsy; seizures were generally benign with good outcomes.
Conclusions:
- Acute gastroenteritis-associated encephalopathy, characterized by seizures, is a benign condition with an excellent prognosis.
- Rotavirus is a significant risk factor for encephalopathy in children with acute gastroenteritis.
- The underlying mechanism for seizures in this context remains unknown, but outcomes are favorable.
Abstract:
We studied the incidence of convulsions in 1936 children with acute gastroenteritis. Sixty-eight children had convulsions (3.5%), which were categorized into three groups: (1) bacterial (n = 13; 19%), (2) Rotavirus (n = 30, 44%), and (3) no organism (n = 25; 37%). Only group 2 versus group 3 had a significant association with encephalopathy (P < .002). The relative risk was estimated to determine the risk of encephalopathy: Rotavirus versus no organism isolated (relative risk = 2.308), Rotavirus versus bacterial (relative risk = 1.846), and bacterial versus no organism (relative risk = 1.25). None developed epilepsy. Thus, acute gastroenteritis-related encephalopathy is a benign condition with single or recurrent seizures during an episode of acute gastroenteritis and an excellent prognosis. The underlying mechanism for provoking seizure is unknown. One should be reassured of a good outcome in the majority of children with recurrent episodes of afebrile/febrile seizures during an episode of acute gastroenteritis.