Uemura Naoko, Okumura Akihisa, Negoro Tamiko, Watanabe Kazuyoshi
Department of Pediatrics, Mitsubishi Nagoya Hospital, 7-8 Sotodoi-cho, Atsuta-ku, Nagoya, Japan.
Brain Dev. 2002 Dec;24(8):745-9. doi: 10.1016/s0387-7604(02)00097-9.
The aim of this study is to reveal the detailed clinical features of benign convulsions with mild gastroenteritis (CwG). We studied 114 consecutive episodes in 105 patients with CwG between January 1995 and March 2000. CwG was defined as when a patient met the following two conditions: (a) seizures accompanied the symptoms of gastroenteritis without clinical signs of dehydration or electrolyte derangement and (b) the body temperature remained less than 38.0 degrees C before and after the seizures. Patients with meningitis, encephalitis/encephalopathy or apparent history of epilepsy were excluded. The age of onset ranged from 8 to 52 months (mean, 21.1 +/- 8.4 months). Six patients (6%) had a family history of afebrile convulsions and seven (7%) had one of febrile convulsions. The average interval between the onset of gastroenteritis and that of seizures was 2.3 +/- 1.1 days (range, 1-6 days). The average number of seizures during a single episode was 2.6 +/- 1.5 (range, 1-7). Two or more seizures occurred in 86 (75%) of the 114 episodes. Seizures induced by pain and/or crying were seen in 35 (43%) of 82 episodes. Antiepileptic drugs were administered for 96 episodes. Seizures did not cease after the administration of one kind of antiepileptic drug in 56 episodes (58%). Epilepsy developed in none of the patients. All patients exhibited normal psychomotor development. CwG is characterized by a cluster of seizures that are sometimes induced by pain and/or crying. The seizures are rather refractory to antiepileptic treatment, although the seizure and development outcomes are good.
本研究旨在揭示轻度胃肠炎伴良性惊厥（CwG）的详细临床特征。我们对1995年1月至2000年3月期间105例CwG患者的114次连续发作进行了研究。CwG定义为患者满足以下两个条件：（a）惊厥伴有胃肠炎症状，无脱水或电解质紊乱的临床体征；（b）惊厥前后体温均低于38.0摄氏度。排除患有脑膜炎、脑炎/脑病或有明显癫痫病史的患者。发病年龄为8至52个月（平均21.1±8.4个月）。6例患者（6%）有热性惊厥家族史，7例患者（占7%）有发热惊厥家族史。从胃肠炎发作到惊厥发作的平均间隔时间为2.3±1.1天（范围1至6天）。单次发作惊厥的平均次数为2.6±1.5次（范围1至7次）。114次发作中有86次（75%）发生两次或更多次惊厥。82次发作中有35次（43%）是由疼痛和/或哭闹诱发的惊厥。96次发作使用了抗癫痫药物。56次发作（58%）在使用一种抗癫痫药物后惊厥未停止。所有患者均未发生癫痫。所有患者的精神运动发育均正常。CwG的特点是有时由疼痛和/或哭闹诱发的惊厥发作群。尽管惊厥发作及发育结局良好，但惊厥对抗癫痫治疗相当难治。
