Kawano Gou, Oshige Keiko, Syutou Sinsuke, Koteda Yusuke, Yokoyama Takato, Kim Bong-Gil, Mizuochi Tatsuki, Nagai Kojiro, Matsuda Kentaro, Ohbu Keizo, Matsuishi Toyojiro
Division of Pediatrics and Emergency Medicine, St. Mary's Hospital, Tsubuku-honnmachi, 422, Kurume, Fukuoka 830-00, Japan.
Brain Dev. 2007 Nov;29(10):617-22. doi: 10.1016/j.braindev.2007.03.012. Epub 2007 Jun 4.
Benign convulsions associated with mild gastroenteritis (CwG) are a commonly observed disorder in Asia, especially in infants and seniors. Here, we describe a retrospective study about the clinical features of CwG in 62 children hospitalized at St. Mary's Hospital (Kurume City, Japan) between January 1, 2000 and March 31, 2006, and further evaluate the efficacies of various anticonvulsant treatments for patients with CwG due to either rotavirus or norovirus. Causative diarrheal viruses were detected in 71% of the fecal specimens tested; 30 patients were positive for rotavirus, nine patients were positive for norovirus, two patients were positive for sapovirus, two patients were positive for adenovirus, and one patient was positive for coxackievirus A4. The age of onset for patients with norovirus-positive CwG (16.7+/-2.7 months) was significantly lower than that of patients with rotavirus-positive CwG (23.0+/-8.7 months). The duration of the seizures due to norovirus infection (11.8+/-12.0 h) was significantly longer than that due to rotavirus infection (4.9+/-5.7 h). There were no significant differences between the two groups with regard to the results of blood chemistry analysis, including the concentrations of serum electrolytes, blood glucose levels, and liver function tests. In this preliminary study, the duration of seizures in patients with CwG due to norovirus that was treated with carbamazepine was significantly shorter than the duration of seizures in the patients treated with another anticonvulsant (phenobarbital). Further randomized controlled studies are required to clarify the efficacies of the various anticonvulsants for patients with CwG.
轻度胃肠炎伴发的良性惊厥(CwG)在亚洲是一种常见疾病,尤其在婴幼儿和老年人中。在此,我们描述了一项回顾性研究,该研究针对2000年1月1日至2006年3月31日期间在日本久留米市圣玛丽医院住院的62例儿童CwG的临床特征进行分析,并进一步评估了各种抗惊厥治疗方法对轮状病毒或诺如病毒所致CwG患者的疗效。在所检测的粪便标本中,71%检测出了致病性腹泻病毒;30例患者轮状病毒呈阳性,9例患者诺如病毒呈阳性,2例患者札幌病毒呈阳性,2例患者腺病毒呈阳性,1例患者柯萨奇病毒A4呈阳性。诺如病毒阳性CwG患者的发病年龄(16.7±2.7个月)显著低于轮状病毒阳性CwG患者(23.0±8.7个月)。诺如病毒感染所致惊厥的持续时间(11.8±12.0小时)显著长于轮状病毒感染所致惊厥的持续时间(4.9±5.7小时)。两组在血液化学分析结果方面,包括血清电解质浓度、血糖水平和肝功能测试,均无显著差异。在这项初步研究中,接受卡马西平治疗的诺如病毒所致CwG患者的惊厥持续时间显著短于接受另一种抗惊厥药物(苯巴比妥)治疗的患者。需要进一步开展随机对照研究,以明确各种抗惊厥药物对CwG患者的确切疗效。