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[Infantile convulsions with mild gastroenteritis: epidemiological and clinical characteristics and outcome]
Teodoro Durá-Travé1, María Eugenia Yoldi-Petri, Teresa Molins-Castiella
1Unidad de Neuropediatría, Hospital Virgen del Camino, Servicio Navarro de Salud/Osasunbidea. Pamplona, Navarra, España. tduratra@cfnavarra.es
Insights
Seizures associated with mild gastroenteritis in children are a distinct syndrome with an excellent prognosis. While generally benign, some cases may recur with subsequent gastrointestinal infections.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Clinical Epidemiology
Context:
- Seizures in children can be triggered by various factors, including infections.
- Mild gastroenteritis is a common childhood illness.
- Understanding specific seizure syndromes aids in diagnosis and management.
Purpose:
- To analyze the epidemiological, clinical, and developmental characteristics of children experiencing seizures linked to mild gastroenteritis.
- To improve diagnostic suspicion of this condition in clinical practice.
Summary:
- A retrospective review of 24 children with seizures and mild gastroenteritis was conducted.
- The study found seizures to be brief, generalized, and often associated with rotavirus.
- Normal neurological examinations, cerebrospinal fluid, and EEG findings (in most cases) were noted, with excellent long-term development.
- Recurrences were observed in 20.8% of cases, coinciding with new gastrointestinal issues.
Impact:
- This research helps differentiate seizures associated with gastroenteritis from other causes.
- It provides valuable data for clinicians regarding the prognosis and potential for recurrence.
- Highlights the importance of considering gastroenteritis as a potential trigger for seizures in children.
Aim:
To analyse the epidemiological, clinical and developmental characteristics of a group of children with seizures associated with mild gastroenteritis in order to facilitate the diagnostic suspicion of the condition in daily clinical practice.
Patients And Methods:
We conducted a retrospective review of the medical records of 24 patients who were admitted to hospital between January 2001 and December 2008 because they presented seizures associated with mild gastroenteritis: epidemiological, clinical and developmental data were collected.
Results:
The mean age at diagnosis was 18.1 months. The female/male ratio was 2.8. The interval between the gastro-enteritis and the seizure was 3.8 days. The mean rectal temperature in the seizure was 37.1 degrees C. The mean number of seizures per hospitalisation was 2.2. Seizures were brief (90.6% < or = 5 min) and 96.8% of them were recorded as generalised. Rotavirus antigenemia in faeces was positive in 55.2% of cases. Lab findings, including the cerebrospinal fluid study, were normal. The electroencephalogram, in an immediate post-seizure situation, showed generalised and/or focal paroxysmal activity in four patients. The mean follow-up time was 4.2 years. The mean age of the group is currently 5.7 years, with normal development and level of schooling. Five patients (20.8%) had recurrences coinciding with new bouts of gastroenteritis. One patient, with a history of maternal epilepsy, was later diagnosed with focal epilepsy, and whether it can be related with the earlier presentation of seizures associated with mild gastroenteritis or not is debatable. CONCLUSIONS; Seizures in children associated with mild gastroenteritis are a well-differentiated convulsive syndrome. Prognosis is excellent, but a relatively important percentage of cases tend to have recurrences if there is a new diarrhoeic process.
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