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儿童轻度胃肠炎伴良性惊厥的临床特征及随访

Clinical characteristics and follow-up of benign convulsions with mild gastroenteritis among children.

作者信息

Ma Xiaohong, Luan Shaoyong, Zhao Yiming, Lv Xiumin, Zhang Ruiyun

机构信息

Department of Qingdao Municipal Hospital, Qingdao, Shandong, China.

出版信息

Medicine (Baltimore). 2019 Jan;98(2):e14082. doi: 10.1097/MD.0000000000014082.

Abstract

Benign convulsions with mild gastroenteritis have a high incidence in the North China, previous reports it has been caused by rotavirus infection, which is a non-febrile convulsion. In recent years, we observed that norovirus infection gradually increased all the years round and most of them are febrile convulsion.Retrospective analysis was performed on 55 pediatric patients with benign convulsions with mild gastroenteritis (CWG) who were admitted between January 2010 and January 2015.The median age of the norovirus infection group was greater than that of the rotavirus infection group. Norovirus infection has no obvious seasonality. The peak age of benign CWG onset was less than 3 years (74.5%). In 69.1% of all cases, the temperature was less than 38 °C. In 70.9% of cases, children had experienced more than 2 episodes. In 96.4% of all cases, convulsive episodes were shorter than 5 min. Convulsions mostly occurred within the first 2 days (78.2%) after gastroenteritis tract symptoms. Most episodes featured generalized tonic-clonic seizure (87.3%). Serum Na+ levels were lower while other biochemical test results were normal. Follow-up 2 years attack again (16.8%), intelligence quotient was not reduced.CWG febrile or afebrile occurs most frequently among young children. In addition to the rotavirus, the norovirus might also cause this syndrome. The prognosis is favorable and long-term anti-seizure treatment is considered to be unnecessary.

摘要

轻度胃肠炎伴良性惊厥在华北地区发病率较高,既往报道其由轮状病毒感染引起,属于非发热性惊厥。近年来,我们观察到诺如病毒感染逐年增多,且多数为发热性惊厥。对2010年1月至2015年1月收治的55例轻度胃肠炎伴良性惊厥(CWG)患儿进行回顾性分析。诺如病毒感染组的中位年龄大于轮状病毒感染组。诺如病毒感染无明显季节性。良性CWG发病的高峰年龄小于3岁(74.5%)。所有病例中69.1%体温低于38℃。70.9%的病例惊厥发作超过2次。所有病例中96.4%惊厥发作持续时间短于5分钟。惊厥大多发生在胃肠道症状出现后的头2天内(78.2%)。多数发作表现为全身性强直阵挛发作(87.3%)。血清钠水平较低,而其他生化检查结果正常。随访2年有16.8%再次发作,智商未降低。CWG发热或不发热在幼儿中最常见。除轮状病毒外,诺如病毒也可能引起该综合征。预后良好,无需长期抗惊厥治疗。

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