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Comparison of clinical characteristics between cluster and isolated seizures associated with benign convulsions with
Wei Fan1, Cuiyun Fang2, Yi Yang1
1Department of Pediatrics, Liyang People's Hospital, Liyang, China.
Insights
Cluster seizures in children with convulsions with mild gastroenteritis (CWG) are associated with lower serum sodium and calcium levels but have similar outcomes to isolated seizures. Alert clinicians to these findings for appropriate management.
Area of Science:
- Pediatric Neurology
- Gastroenterology
- Clinical Medicine
Background:
- Cluster seizures are not well-documented in benign convulsions with mild gastroenteritis (CWG).
- CWG is typically associated with serious outcomes, making seizure patterns crucial to understand.
- This study addresses the lack of specific reporting on cluster seizures in CWG.
Purpose of the Study:
- To identify and compare clinical differences between cluster and isolated seizures in children with CWG.
- To investigate the characteristics of CWG patients experiencing cluster seizures versus single seizures.
Main Methods:
- Retrospective analysis of hospitalized children diagnosed with CWG (May 2018 - December 2020).
- Case-control study comparing patients with cluster seizures to those with isolated seizures.
- Comparison of clinical characteristics, including serum electrolyte levels and treatment outcomes.
Main Results:
- 36.6% of CWG patients experienced cluster seizures (n=30) versus 63.4% with isolated seizures (n=52).
- Lower serum sodium and calcium levels were observed in the cluster seizure group compared to the isolated seizure group.
- No significant differences in anticonvulsant therapy outcomes or prognosis were found between the two groups.
Conclusions:
- Clinicians should be vigilant for cluster seizures in CWG patients presenting with reduced sodium and calcium.
- CWG patients with cluster seizures do not necessitate extensive investigations or aggressive anticonvulsant treatment compared to those with isolated seizures.
- Early identification of cluster seizures in CWG can guide appropriate clinical management without over-intervention.
Background And Purpose:
Cluster seizures have not been specifically reported in benign convulsions with mild gastroenteritis (CWG), which are usually considered to have serious outcomes. We aimed to identify the differences between cluster and isolated seizures associated with CWG.
Method:
We retrospectively analyzed the medical data of children hospitalized and diagnosed with CWG from May 2018 to December 2020. A case-control study approach was adopted and patients who met the inclusion criteria were divided into a cluster seizures group and an isolated seizures group. Then, the clinical characteristics of the patients in the two groups were compared.
Results:
30 patients（36.6%） were in the cluster seizures group while 52 patients (63.4%) were in the isolated seizures group. The highest incidence of CWG occurs between 12 and 24 months of age. While serum sodium and calcium were within the normal range for both groups, they were lower in the cluster seizures group compared to the isolated seizures group (136.74 ± 2.78 vs 134.65 ± 2.85, P = 0.002; 2.43 ± 0.13 vs 2.37 ± 0.14, P = 0.04). A total of 123 seizures was recorded during the research period and 25 were treated with anticonvulsant drugs. The outcome of anticonvulsant therapy and the prognosis showed no differences between the two groups.
Conclusion:
Clinicians need to be highly alert to the possibility of cluster seizures in CWG patients who have reduced sodium and calcium. Besides, CWG patients with cluster seizures do not require excessive investigations, overuse of anticonvulsant therapy compared to those with isolated seizures.
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