Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan; Brain and Mind Research Center, Nagoya University, Nagoya, Japan.
Pediatr Neurol. 2020 Aug;109:79-84. doi: 10.1016/j.pediatrneurol.2019.05.002. Epub 2019 May 9.
To investigate clinical risk factors for acute magnetic resonance imaging (MRI) abnormalities in patients with benign convulsions with mild gastroenteritis or benign infantile epilepsy.
We investigated clinical and diffusion-weighted imaging findings in 32 patients with benign convulsions with mild gastroenteritis and 22 patients with benign infantile epilepsy who underwent MRI within seven days of seizure onset between 2010 and 2015.
Diffusion-weighted imaging showed signal hyperintensity in the splenium of the corpus callosum in seven patients with benign convulsions with mild gastroenteritis, but no abnormalities in patients with benign infantile epilepsy. Patients with benign convulsions with mild gastroenteritis with splenial lesions showed a higher rate of rotavirus detection from feces (P = 0.006), higher serum level of C-reactive protein (P = 0.04), and shorter interval between seizure onset and MRI (P = 0.002) than patients with benign convulsions with mild gastroenteritis without splenial lesions. Multivariate analysis revealed rotavirus infection as a significant risk factor for splenial lesions on diffusion-weighted imaging in patients with benign convulsions with mild gastroenteritis (P = 0.02).
Splenial lesions are often seen during acute period in patients with benign convulsions with mild gastroenteritis. Rotavirus infection is a risk factor for splenial lesions in patients with benign convulsions with mild gastroenteritis, suggesting the role of rotavirus to cause edema in the corpus callosum. From our observations, benign convulsions with mild gastroenteritis with a splenial lesion on diffusion-weighted imaging suggests good outcomes, and extensive evaluation of these patients may be unnecessary.
研究轻度胃肠炎性良性惊厥和婴儿良性癫痫患者急性磁共振成像（MRI）异常的临床危险因素。
我们调查了 2010 年至 2015 年间 32 例轻度胃肠炎性良性惊厥和 22 例婴儿良性癫痫患者的临床和弥散加权成像（DWI）表现，这些患者在癫痫发作后 7 天内行 MRI 检查。
DWI 显示 7 例轻度胃肠炎性良性惊厥患者胼胝体压部信号高，而婴儿良性癫痫患者无异常。胼胝体病变患者粪便轮状病毒检出率较高（P=0.006），血清 C 反应蛋白水平较高（P=0.04），癫痫发作与 MRI 检查时间间隔较短（P=0.002）。多因素分析显示，轮状病毒感染是轻度胃肠炎性良性惊厥患者 DWI 胼胝体病变的显著危险因素（P=0.02）。
轻度胃肠炎性良性惊厥患者急性期常出现胼胝体病变。轮状病毒感染是轻度胃肠炎性良性惊厥患者胼胝体病变的危险因素，提示轮状病毒可能导致胼胝体水肿。从我们的观察结果来看，轻度胃肠炎性良性惊厥伴 DWI 胼胝体病变的患者预后良好，可能无需对这些患者进行广泛评估。
