Falsaperla Raffaele, Romano Catia, Pavone Piero, Vitaliti Giovanna, Yuan Qian, Motamed-Gorji Nazgole, Lubrano Riccardo
General Paediatrics Complex Operative Unit, Policlinico-Vittorio Emanuele University Hospital, University of Catania, Catania, Italy.
Clinical Director, Food Allergy Center, Pediatrician, Pediatric Gastroenterology and Nutrition, Massachusetts General Hospital, Department of Pediatrics, Harvard Medical School, Boston, USA.
J Pediatr Neurosci. 2017 Jan-Mar;12(1):105-108. doi: 10.4103/jpn.JPN_190_16.
Recent literature data have given emphasis to the relationship between gastrointestinal (GI) disorders and neurologic diseases, underlying a new pathogenic pathway: The so-called "gut-brain axis." Herein, authors report a case of a 10-month-old male infant, admitted for drug-resistant epilepsy, associated with irritable behavior and GI discomfort, secondary to cow's milk protein allergy. Seizures were described by parents as upward eye movements that were mostly deviated to the right and were associated with slight extension of his neck. They were infrequent at first, but had increased gradually during the course of 3 days (up to 15-20 times/day). No anticonvulsant therapy was effective. Only a cow's milk protein-free diet, accidentally started during a gastroenteritis episode, was effective in stopping seizures. Our case underlines the peculiar vulnerability of the blood-brain barrier under 1 year of age, for which children of this age group experience neurologic manifestations during episodes of systemic inflammation.
近期文献数据强调了胃肠道（GI）疾病与神经系统疾病之间的关系，揭示了一条新的致病途径：即所谓的“肠-脑轴”。在此，作者报告了一例10个月大的男婴，因耐药性癫痫入院，伴有易激惹行为和胃肠道不适，继发于牛奶蛋白过敏。父母描述其癫痫发作表现为眼球向上运动，大多偏向右侧，并伴有颈部轻微伸展。起初发作不频繁，但在3天内逐渐增多（多达每天15 - 20次）。没有抗惊厥治疗有效。仅在一次胃肠炎发作期间偶然开始的无牛奶蛋白饮食有效地停止了癫痫发作。我们的病例强调了1岁以下儿童血脑屏障的特殊脆弱性，该年龄组的儿童在全身炎症发作期间会出现神经学表现。
