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Rotavirus gastroenteritis associated with afebrile seizure in childhood
1Department of Pediatrics, National Taiwan University Hospital, Taipei, R.O.C.
Insights
Rotavirus gastroenteritis in children can lead to afebrile seizures. These seizures, often linked to rotavirus serotype G1, typically resolve without recurrence, indicating a generally benign outcome.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Acute diarrhea is a common pediatric illness.
- Seizures can occur in children following gastrointestinal infections.
- Rotavirus is a leading cause of gastroenteritis in young children.
Purpose of the Study:
- To investigate the relationship between rotavirus infection and afebrile seizures in children.
- To characterize the clinical presentation and outcomes of children experiencing seizures after rotavirus gastroenteritis.
Main Methods:
- Case series of eight children presenting with acute diarrhea followed by seizures.
- Stool examination for rotavirus identification and serotyping using reverse transcription-polymerase chain reaction (RT-PCR).
- Biochemical analysis, cerebrospinal fluid (CSF) examination, and electroencephalograms (EEGs) were performed.
Main Results:
- Rotavirus (serotype G1) was identified as the causative agent in all eight children.
- Serum electrolytes and CSF examinations were normal; cultures were negative.
- Electroencephalograms (EEGs) showed abnormalities in six patients initially, but follow-up EEGs were normal.
- No seizure recurrence was observed in any patient without long-term anticonvulsant therapy.
Conclusions:
- A strong association exists between rotavirus gastroenteritis and afebrile seizures in children.
- Afebrile seizures following rotavirus infection appear to have a benign clinical course.
- Further research is warranted to understand the pathogenesis of rotavirus-associated seizures.
Abstract:
From September 1994 to April 1995, we encountered eight children, two boys and six girls, (aged 1 year 6 months to 9 years), presented with acute diarrhea followed by afebrile, generalized tonic-clonic seizures, or transient loss of consciousness with urine incontinence. Their biochemical data, including serum electrolyte levels, were within normal limits. The infective agent causing diarrhea was later proved by stool examination to be rotavirus, judged to be serotype G1 by reverse transcription - polymerase chain reaction (RT-PCR) typing. Cerebrospinal fluid (CSF) examinations performed in seven of the eight patients were within normal limits, and cultures for bacteria and virus were negative. The electroencephalograms (EEGs) performed from 1 to 13 days after seizure showed abnormal in six, and normal in two, patients. Follow-up EEGs, performed from 4 to 11 months after onset of seizure, were all normal. None had seizure recurrence despite the fact that no long-term anticonvulsant had been given. From observation here, the authors emphasize that there is a close relationship between rotavirus and afebrile seizure, and the course of afebrile seizure following rotavirus gastroenteritis is usually benign. Further studies are needed to elucidate the underlying pathogenesis.