Asymptomatic viral gastrointestinal infection: the missing link?

Tyler Robert Peikes1, Juan Pablo Appendino

  • 1University of Manitoba Faculty of Medicine, Section of Genetics and Metabolism, Winnipeg Regional Health Authority, Winnipeg, Manitoba, Canada;

Pediatrics
|February 4, 2014
PubMed

Insights

Benign infantile seizures associated with mild gastroenteritis (BISMG) can manifest solely as seizures, even without gastrointestinal symptoms. This condition may present as apparent life-threatening events in infants.

Area of Science:

  • Pediatrics
  • Neurology
  • Infectious Disease

Background:

  • Infantile seizures can present with varied etiologies.
  • Apparent life-threatening events (ALTEs) require thorough investigation.
  • Benign infantile seizures associated with mild gastroenteritis (BISMG) is a recognized, though less common, cause of seizures.

Observation:

  • An 8-month-old boy experienced recurrent apneic episodes and seizures.
  • Standard investigations including EEG and MRI were unremarkable.
  • Stool virology identified a small round virus, leading to a diagnosis of BISMG despite absent GI symptoms.

Findings:

  • The patient's seizures resolved after phenobarbital administration.
  • The clinical presentation mimicked typical BISMG, suggesting a viral etiology.
  • Atypical presentation of BISMG without gastrointestinal symptoms was observed.

Implications:

  • BISMG may present solely with seizures, without overt gastrointestinal manifestations.
  • BISMG should be considered in the differential diagnosis of ALTEs in infants.
  • This case highlights the importance of considering viral gastroenteritis as a cause of neurological symptoms in infants.

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