Iannetti P, Fiorilli M, Sirianni M C, Paná A, Aiuti F
J Pediatr. 1982 Jul;101(1):27-31. doi: 10.1016/s0022-3476(82)80174-1.
Twelve hundred children with convulsions when feverish were studied during a period of five years. Among them 52 subjects (4.33%) developed nonfebrile seizures after a period of eight months to five years from the first febrile convulsion (group A). Twenty-three children had neither afebrile seizures nor EEG abnormalities during the period of observation (group B). The two groups were comparable for age of the first febrile convulsion onset, sex, and socioeconomic status. None had risk factors for subsequent epilepsy or clinical signs of congenital cytomegalovirus infection. The isolation rate of CMV from urine was 53.84% in patients of group A, 26.09% in children of group B, and 26.83% in healthy control children. Twelve CMV-positive children from group A were followed for one to more than three years. In five of seven children with persisting EEG abnormalities, cytomegaloviruria was still present 13 to 41 months after the first isolation, whereas none of five patients with normal electroencephalograms had viruria after a comparable period. We found that CMV-positive children generally lacked cell-mediated immunity to the virus, whereas CMV-negative patients had positive reactions. Our data suggest a correlation between persistence of neurologic abnormalities and CMV excretion in children with nonfebrile seizures and CMV infection.
在五年期间对1200名发热时惊厥的儿童进行了研究。其中52名受试者（4.33%）在首次热性惊厥后的8个月至5年期间出现了无热惊厥（A组）。23名儿童在观察期间既没有无热惊厥也没有脑电图异常（B组）。两组在首次热性惊厥发作的年龄、性别和社会经济地位方面具有可比性。没有人有后续癫痫的危险因素或先天性巨细胞病毒感染的临床体征。A组患者尿液中巨细胞病毒的分离率为53.84%，B组儿童为26.09%，健康对照儿童为26.83%。对A组的12名巨细胞病毒阳性儿童进行了1至3年以上的随访。在7名脑电图持续异常的儿童中，有5名在首次分离后13至41个月仍有巨细胞病毒尿，而5名脑电图正常的患者在相当长的一段时间后均无病毒尿。我们发现巨细胞病毒阳性儿童通常缺乏对该病毒的细胞介导免疫，而巨细胞病毒阴性患者则有阳性反应。我们的数据表明，在无热惊厥和巨细胞病毒感染的儿童中，神经学异常的持续存在与巨细胞病毒排泄之间存在相关性。
