1
|
Na H, Lee S, Kim SH, Kim YO. Changes in frequency of benign convulsions with mild gastroenteritis and their viral causes before and during the COVID-19 pandemic: a single-center study. Clin Exp Pediatr 2024; 67:213-220. [PMID: 38500238 PMCID: PMC10990658 DOI: 10.3345/cep.2023.01137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 12/30/2023] [Accepted: 01/04/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Benign convulsions with mild gastroenteritis (CwG) are prevalent in young children during the winter. Early in the coronavirus disease 2019 (COVID-19) pandemic, viral gastroenteritis occurrence decreased and seasonal variation was lost, which can change CwG. PURPOSE Here we investigated changes in frequency, seasonal variation, and causative viruses of CwG during the COVID-19 pandemic. METHODS We screened 1134 patients (3-36 months) with "other and unspecified convulsions" treated at Chonnam National University Hospital between March 2017 and February 2023; of them, we enrolled 41 (3.6%) with CwG. We compared their medical records from period I (March 2017 to February 2020) to those from period II (March 2020 to February 2023). Publicly available viral gastroenteritis surveillance data from the Korea Disease Control and Prevention Agency (KDCA) were reviewed as reference. RESULTS Of the 41 patients with CwG, 18 (2.9% of 613) were affected in period I versus 23 (4.4% of 512) in period II (P=0.184). In period I, CwG mainly occurred in winter and spring (55.6% and 22.2%, respectively). In period II, there were fewer CwG cases (39.1%) in winter and more cases in summer and autumn (26.1% and 17.4%, respectively): the cases of norovirus genogroup II (GII)-associated CwG increased significantly in the summer (38.5% vs. 0%, P= 0.046). Norovirus GII was the most common virus (56.1% of isolates). Enteric adenovirus was the second most common (19.5%), with one case in period I and 7 cases in period II (P=0.059). The clinical characteristics of enteric adenovirus-associated CwG were similar to those of norovirus. Seasonal changes in and viral causes of CwG were consistent with those observed in the KDCA stool surveillance data. CONCLUSION During the COVID-19 pandemic, CwG frequency did not change, seasonal variation was unapparent, and enteric adenovirus-associated CwG frequency increased.
Collapse
Affiliation(s)
- Hyejin Na
- Department of Pediatrics, Chonnam National University Medical School, Gwangju, Korea
- Department of Pediatrics, Chonnam University Children’s Hospital, Gwangju, Korea
| | - Sanghoon Lee
- Department of Pediatrics, Chonnam University Children’s Hospital, Gwangju, Korea
| | - Seo Hee Kim
- Department of Pediatrics, Chonnam University Children’s Hospital, Gwangju, Korea
| | - Young Ok Kim
- Department of Pediatrics, Chonnam National University Medical School, Gwangju, Korea
- Department of Pediatrics, Chonnam University Children’s Hospital, Gwangju, Korea
| |
Collapse
|
2
|
Shi K, Jiang D, Yang J, Li Y, Chen W, Li P. Clinical characteristics and follow-up of children with norovirus-associated benign convulsions with mild gastroenteritis. Epilepsia Open 2023; 8:1049-1053. [PMID: 37394877 PMCID: PMC10472357 DOI: 10.1002/epi4.12782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 06/29/2023] [Indexed: 07/04/2023] Open
Abstract
OBJECTIVE Explore the clinical characteristics and prognosis of children with norovirus (NoV)-associated benign convulsions with mild gastroenteritis (CwG). METHODS We retrospectively analyzed the Clinical and laboratory data of children with NoV-associated CwG admitted to the emergency department of Guangzhou Children's Hospital between January 2019 and January 2020. And patients were followed up for 23-36 months. RESULTS There are 49 cases met the CwG criteria. Vomiting was the first symptom in 31 (63.3%) patients, and vomiting could be the main or the only gastrointestinal symptom. The mean frequency of seizures was 3.8 ± 2.4 episodes. Most patients (95.9%) experienced seizures that lasted for less than 5 min. Of the 43 (87.8%) cases followed up from 23 to 36 months, only one experienced recurrent convulsions (after rotavirus infection). SIGNIFICANCE NoV-associated CwG patients were prone to experiencing more convulsions. However, because most NoV-associated CwG patients had good prognosis, long-term use of anticonvulsants are unnecessary.
Collapse
Affiliation(s)
- Kaili Shi
- Department of NeurologyGuangzhou Women and Children's Medical CenterGuangzhouChina
| | - Daoju Jiang
- Department of EmergencyGuangzhou Women and Children's Medical CenterGuangzhouChina
| | - Jiehui Yang
- Department of NeurologyChildren's Hospital of Shanxi ProvinceTaiyuanChina
| | - Ying Li
- Department of NeurologyGuangzhou Women and Children's Medical CenterGuangzhouChina
| | - Wenxiong Chen
- Department of NeurologyGuangzhou Women and Children's Medical CenterGuangzhouChina
| | - Peiqing Li
- Department of EmergencyGuangzhou Women and Children's Medical CenterGuangzhouChina
| |
Collapse
|
3
|
Cappellari AM, Mariani S, Bruschi G. Febrile seizures and convulsions with mild gastroenteritis: age-dependent acute symptomatic seizures. Front Pediatr 2023; 11:1151770. [PMID: 37534200 PMCID: PMC10390780 DOI: 10.3389/fped.2023.1151770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 06/26/2023] [Indexed: 08/04/2023] Open
Abstract
Background Febrile seizures (FS) and benign convulsions in children with mild gastroenteritis (CwG) are acute symptomatic seizures, transiently occurring in infants and young children, probably related to the immaturity of the brain. Our paper aims to review the literature data on patients with FS and CwG. Methods A review of series of patients with FS and CwG was performed by literature search on PubMed January 1960 to October 2022. Several parameters were considered, including epidemiology, pathophysiology, clinical features, electroencephalographic findings and other diagnostic studies, and treatment. Results FS and CwG share an age-dependent course, but they show significant differences in the pathophysiology, clinical features, diagnostic studies, and treatment. Conclusion Acute symptomatic seizures include seizures that are caused by acute structural brain pathologies, such as stroke, as well as seizures that are provoked by a reversible factor, such as hyponatraemia, although the two groups should be not equated. Furthermore, FS and CwG should be set apart as "age-dependent acute symptomatic seizures", reinforcing the concept of their self-limited course over a certain period.
Collapse
Affiliation(s)
- Alberto M. Cappellari
- Department of Neuroscience and Mental Health, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Mariani
- Department of Medical-Surgical and Transplant Pathophysiology, University of Milan, Milan, Italy
| | - Gaia Bruschi
- Department of Medical-Surgical and Transplant Pathophysiology, University of Milan, Milan, Italy
| |
Collapse
|
4
|
Fang C, Fan W, Zhang C, Yang Y. Risk Factors for Benign Convulsions With Mild Gastroenteritis. Front Pediatr 2022; 10:925896. [PMID: 35844760 PMCID: PMC9277103 DOI: 10.3389/fped.2022.925896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Objective To investigate the risk factors for benign convulsions with mild gastroenteritis (CwG) and provide a basis for the early identification and diagnosis. Method We selected children with CwG and acute gastroenteritis in the same period who attended the pediatric department of the Liyang People's Hospital from June 2018 to June 2021. A retrospective analysis of the general data, clinical characteristics, and laboratory test results of the two groups was performed. Finally, we conducted a multifactorial logistic regression analysis to derive the risk factors for CwG. Results A total of 82 children were included in the CwG and 93 children were included in the acute gastroenteritis group. Univariate analysis showed no significant differences in gender, age, vomiting, diarrhea, neutrophil, lymphocyte, hemoglobin, platelets, and serum calcium. Statistically significant differences were found in onset season, rotavirus, white blood cells, aspartate aminotransferase, alanine transaminase, serum sodium, and uric acid. Finally, multifactorial logistic regression analysis showed rotavirus (OR, 3.042, 95% CI, 1.116-8.289, p = 0.030), serum sodium (OR, 0.811, 95% CI, 0.684-0.962, p = 0.016) and uric acid (OR, 1.018, 95% CI, 1.012-1.024, p = 0.000) to be independent risk factors. Conclusion Characteristics of gastroenteritis symptoms such as vomiting and diarrhea cannot be used to predict the onset of CwG. Rotavirus is an independent risk factor for CwG, and decreased serum sodium and increased uric acid can be used as early warning indicators for CwG.
Collapse
Affiliation(s)
- Cuiyun Fang
- Department of Nursing, Liyang People's Hospital, Liyang, China
| | - Wei Fan
- Department of Pediatrics, Liyang People's Hospital, Liyang, China
| | - Chunsheng Zhang
- Department of Pediatrics, Liyang People's Hospital, Liyang, China
| | - Yi Yang
- Department of Pediatrics, Liyang People's Hospital, Liyang, China
| |
Collapse
|
5
|
Fan W, Fang C, Yang Y, Zhang C. Comparison of clinical characteristics between cluster and isolated seizures associated with benign convulsions with mild gastroenteritis. Eur J Paediatr Neurol 2022; 36:26-29. [PMID: 34823071 DOI: 10.1016/j.ejpn.2021.11.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 08/03/2021] [Accepted: 11/16/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND AND PURPOSE Cluster seizures have not been specifically reported in benign convulsions with mild gastroenteritis (CWG), which are usually considered to have serious outcomes. We aimed to identify the differences between cluster and isolated seizures associated with CWG. METHOD We retrospectively analyzed the medical data of children hospitalized and diagnosed with CWG from May 2018 to December 2020. A case-control study approach was adopted and patients who met the inclusion criteria were divided into a cluster seizures group and an isolated seizures group. Then, the clinical characteristics of the patients in the two groups were compared. RESULTS 30 patients(36.6%) were in the cluster seizures group while 52 patients (63.4%) were in the isolated seizures group. The highest incidence of CWG occurs between 12 and 24 months of age. While serum sodium and calcium were within the normal range for both groups, they were lower in the cluster seizures group compared to the isolated seizures group (136.74 ± 2.78 vs 134.65 ± 2.85, P = 0.002; 2.43 ± 0.13 vs 2.37 ± 0.14, P = 0.04). A total of 123 seizures was recorded during the research period and 25 were treated with anticonvulsant drugs. The outcome of anticonvulsant therapy and the prognosis showed no differences between the two groups. CONCLUSION Clinicians need to be highly alert to the possibility of cluster seizures in CWG patients who have reduced sodium and calcium. Besides, CWG patients with cluster seizures do not require excessive investigations, overuse of anticonvulsant therapy compared to those with isolated seizures.
Collapse
Affiliation(s)
- Wei Fan
- Department of Pediatrics, Liyang People's Hospital, Liyang, China.
| | - Cuiyun Fang
- Department of Surgery, Liyang People's Hospital Hospital, China
| | - Yi Yang
- Department of Pediatrics, Liyang People's Hospital, Liyang, China
| | - Chunsheng Zhang
- Department of Pediatrics, Liyang People's Hospital, Liyang, China
| |
Collapse
|
6
|
Rice SA, Müller RM, Jeschke S, Herziger B, Bertsche T, Neininger MP, Bertsche A. Febrile seizures: perceptions and knowledge of parents of affected and unaffected children. Eur J Pediatr 2022; 181:1487-1495. [PMID: 34873647 PMCID: PMC8648401 DOI: 10.1007/s00431-021-04335-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/26/2021] [Accepted: 11/29/2021] [Indexed: 11/21/2022]
Abstract
UNLABELLED Febrile seizures (FS) in children are common, but little is known about parents' perceptions and knowledge of FS. We interviewed parents of children aged 6 months to 6 years affected by FS (FS group, 65 parents) or unaffected (control group, 54 parents). In the FS group, 32% said they knew their child had an FS when the first event occurred, and 89% described fear when the child had a seizure, with a median intensity of 10/10 (Q25/Q75: 9/10). Related to follow-up, 77% in the FS group (will) observe their child more carefully after the first seizure happened, and 63% (will) give antipyretics earlier at a median temperature of 38.2 °C (100.8 °F). In the FS group, 62% were unaware of FS before the first event (54% of control group did not know about FS thus far, n.s.). In the FS group, 20% would put a solid object in the mouth of a child having a seizure (control group, 39%, p = 0.030), and 92% would administer an available anti-seizure rescue medication (control group, 78%, p = 0.019). In the FS group, 71% feared that children with FS might suffocate (control group, 70%, n.s.). CONCLUSION Information about FS and their management should be more available to improve parents' coping and patient safety. WHAT IS KNOWN • Febrile seizures in children are common. • The prognosis of children suffering from febrile seizures is usually rather good. WHAT IS NEW • Over half of parents had not informed themselves about febrile seizures so far; and only 32% of parents realized their child had a febrile seizure when it occurred. • Most parents described own fear with a median intensity of 10/10; and 63% (will) give antipyretics earlier at a median temperature of 38.2 °C (100.8 °F).
Collapse
Affiliation(s)
- Steven Alan Rice
- University Hospital for Children and Adolescents, Universitätsmedizin Rostock, Ernst-Heydemann-Straße 8, Rostock, 18057 Germany
| | - Ruth Melinda Müller
- University Hospital for Children and Adolescents, Universitätsmedizin Rostock, Ernst-Heydemann-Straße 8, Rostock, 18057 Germany
| | - Sarah Jeschke
- University Hospital for Children and Adolescents, Universitätsmedizin Rostock, Ernst-Heydemann-Straße 8, Rostock, 18057 Germany
| | - Birthe Herziger
- University Hospital for Children and Adolescents, Universitätsmedizin Rostock, Ernst-Heydemann-Straße 8, Rostock, 18057 Germany
| | - Thilo Bertsche
- Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University and Drug Safety Center, Leipzig University and University Hospital, Bruederstraße 32, Leipzig, 04103 Germany
| | - Martina Patrizia Neininger
- Clinical Pharmacy, Institute of Pharmacy, Medical Faculty, Leipzig University and Drug Safety Center, Leipzig University and University Hospital, Bruederstraße 32, Leipzig, 04103 Germany
| | - Astrid Bertsche
- University Hospital for Children and Adolescents, Universitätsmedizin Rostock, Ernst-Heydemann-Straße 8, Rostock, 18057, Germany.
| |
Collapse
|
7
|
Wang D, Jiang Y, Hong S, Ma J, Liao S, Cheng M, Li T, Jiang L. Prognostic factors for the recurrence of afebrile seizures after benign convulsions associated with mild gastroenteritis. Epilepsia 2021; 62:3068-3075. [PMID: 34668572 DOI: 10.1111/epi.17102] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 10/02/2021] [Accepted: 10/05/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE The overall prognosis of benign convulsions associated with mild gastroenteritis (CwG) is favorable, and the incidence of afebrile seizure recurrence with or without gastroenteritis (ASwGI and ASwoGI, respectively) is low. In this study we investigated the prognostic factors associated with afebrile seizure (AS) relapse after the first CwG episode. METHODS A hospital-based cohort with an initial CwG episode from January 2012 to October 2019 was followed for at least 19 months. The relapse types were divided into ASwGI and ASwoGI. Logistic regression analysis was performed to identify the independent prognostic factors for the recurrence of AS after the initial CwG episode. Furthermore, the clinical characteristics between ASwGI and ASwoGI were compared. RESULTS Among the 868 patients enrolled, 67 (7.7%) experienced a second AS and 71% (48/67) showed gastroenteritis-associated recurrence. Except for five patients with subsequent epilepsy (0.6%), only eight (0.9%) experienced three seizure episodes. The independent predictive factors for the subsequent recurrence of AS were age less than 18 months at onset (odds ratio [OR]: 2.93, 95% confidence interval [CI]: 1.53-5.63), repeated seizures over 24 h (OR: 4.09, 95% CI: 2.19-7.65), and absence of fever (OR: 2.33, 95% CI: 1.26-4.33) during the first CwG episode. The probability of recurrence of AS for those with one, two, and three predictive factors was 3.23%, 13.35%, and 22.85%, respectively. In addition, the age at onset was significantly lower in the ASwoGI group than in the ASwGI group during the first episode (p < .05). SIGNIFICANCE The risk of AS relapse after the initial CwG episode is low, and the majority of patients presented with gastroenteritis. The risk can be predicted by age at onset, repeated seizures over 24 h, and absence of fever during the first CwG episode.
Collapse
Affiliation(s)
- Duan Wang
- Department of Neurology, Children's Hospital of Chongqing Medical University(CHCMU), Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Yu Jiang
- Department of Neurology, Children's Hospital of Chongqing Medical University(CHCMU), Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Siqi Hong
- Department of Neurology, Children's Hospital of Chongqing Medical University(CHCMU), Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Jiannan Ma
- Department of Neurology, Children's Hospital of Chongqing Medical University(CHCMU), Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Shuang Liao
- Department of Neurology, Children's Hospital of Chongqing Medical University(CHCMU), Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Min Cheng
- Department of Neurology, Children's Hospital of Chongqing Medical University(CHCMU), Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Chongqing, China
| | - Tingsong Li
- Ministry of Education Key Laboratory of Child Development and Disorders, International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Chongqing, China.,Department of Rehabilitation, CHCMU, Chongqing, China
| | - Li Jiang
- Department of Neurology, Children's Hospital of Chongqing Medical University(CHCMU), Chongqing, China.,Ministry of Education Key Laboratory of Child Development and Disorders, International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, National Clinical Research Center for Child Health and Disorders, Chongqing, China
| |
Collapse
|
8
|
Iflah M, Kassem E, Rubinstein U, Goren S, Ephros M, Cohen D, Muhsen K. Convulsions in children hospitalized for acute gastroenteritis. Sci Rep 2021; 11:15874. [PMID: 34354134 PMCID: PMC8342430 DOI: 10.1038/s41598-021-95202-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/21/2021] [Indexed: 11/09/2022] Open
Abstract
The study aim was to examine possible correlates of convulsions in children hospitalized for acute gastroenteritis (AGE). Data collected in a prospective study of AGE hospitalizations in children aged 0-59 months in 3 hospitals in Israel during 2008-2015 were analyzed. Stool samples were tested for rotavirus using immunochromatography and stool culture was performed for the detection of Salmonella, Shigella and Campylobacter We compared clinical and demographic characteristics of children hospitalized for AGE who had convulsions (n = 68, cases) with children hospitalized for AGE without convulsions (n = 3505, controls). Age differed between children with and without convulsions (p = 0.005); the former were mostly toddlers aged 12-23 months (51%) compared to 30% of the control group. A higher percentage of cases tested positive for Shigella (11% vs. 4%, p = 0.002), the opposite was found for rotavirus (2% vs. 30% p < 0.001). A multivariable model showed that body temperature (OR 2.91 [95% CI 1.78-4.76], p < 0.001) and high blood glucose level (> 120 mg/dL) (OR 5.71 [95% CI 1.27-25.58] p = 0.023) were positively related to convulsions in children with AGE, while severe AGE (Vesikari score ≥ 11) was inversely related with convulsions (OR 0.09 [95% CI 0.03-0.24], p < 0.001). Conclusion: Elevated body temperature is associated with convulsions in children with AGE, but not severity of AGE, while hyperglycemia might reflect a neuroendocrine stress reaction to convulsions, AGE or both.
Collapse
Affiliation(s)
- Moti Iflah
- School of Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eias Kassem
- Department of Pediatrics, Hillel Yaffe Medical Center, Hadera, Israel
| | - Uri Rubinstein
- Department of Pediatrics, Laniado Medical Center, Netanya, Israel
| | - Sophy Goren
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 6139001, Tel Aviv, Israel
| | - Moshe Ephros
- Department of Pediatrics, Carmel Medical Center, Haifa, Israel.,Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Dani Cohen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 6139001, Tel Aviv, Israel
| | - Khitam Muhsen
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, 6139001, Tel Aviv, Israel.
| |
Collapse
|
9
|
Kim DH, Ha DJ, Lee YS, Chun MJ, Kwon YS. Benign Convulsions with Mild Rotavirus and Norovirus Gastroenteritis: Nationwide Data from the Health Insurance Review and Assessment Service in South Korea. CHILDREN-BASEL 2021; 8:children8040263. [PMID: 33808239 PMCID: PMC8065692 DOI: 10.3390/children8040263] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 11/16/2022]
Abstract
There have been no large-scale studies on the epidemiology of benign convulsions with mild gastroenteritis (CwG) since the introduction of the rotavirus vaccine in South Korea in 2007. This study aimed to analyze the trends in rotavirus gastroenteritis (RVGE) and rotavirus-associated CwG (RaCwG) after rotavirus vaccination. Further, we aimed to analyze changes in norovirus gastroenteritis (NVGE) and norovirus-associated CwG (NaCwG) using nationwide data from the Korean Health Insurance Review and Assessment Service. Between 2007 and 2019, this study analyzed children aged <6 years who were diagnosed with RVGE, NVGE, RaCwG and NaCwG. The changes in the prevalence of each disease and the ratio of CwG to enteritis were analyzed and the effects of age, sex and season were also analyzed. RVGE, RaCwG, NVGE and NaCwG were diagnosed in 273,898, 4246, 35,593 and 337 patients, respectively. The prevalence of RVGE was on a decreasing trend every year, but the prevalence of NaCwG and NVGE was on an increasing trend. There was a significant annual increase in the ratio of CwG to enteritis in both viruses. In order to control the prevalence of RaCwG, measures other than the rotavirus vaccine are required and measures to prevent norovirus are necessary.
Collapse
|
10
|
Chen H, Chen Y, Zhong JM. Detection and diagnostic value of serum NSE and S100B protein levels in patients with seizures associated with mild gastroenteritis: A retrospective observational study. Medicine (Baltimore) 2020; 99:e23439. [PMID: 33235129 PMCID: PMC7710215 DOI: 10.1097/md.0000000000023439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Benign convulsions with mild gastroenteritis (CwG) and febrile seizures (FS) associated with mild gastroenteritis are 2 different diseases in the spectrum of seizures associated with mild gastroenteritis. However, specific and useful indicators for the identification of the 2 diseases are lacking. A retrospective analysis was performed to compare the serum neuronal-specific enolase (NSE) and S100B protein levels between patients with these 2 diseases to evaluate the value of NSE and S100B for differential diagnosis between these 2 diseases.The clinical data and NSE and S100B protein levels of 81 children with seizure-associated mild gastroenteritis were collected. According to the axillary temperature at the time of convulsions, all patients were classified into an afebrile seizure (AFS) group, hereafter called the CwG group (n = 46), and a febrile seizure group (FS group, n = 35).The serum NSE level was higher in the CwG group than in the FS group (14.046 (11.095, 19.266) pg/ml and 9.034 (7.158, 12.165) pg/ml, respectively, P < .001); however, the serum S100B protein levels in the CwG and the FS group were not significantly different (P > .05). Receiver operating characteristic (ROC) curve analysis showed that the area under the curve (AUC) for NSE was 0.806, P = .000, which was statistically significant. The Youden index was largest (0.605) for a serum NSE cut-off value of 10.460 pg/ml, which yielded a sensitivity and specificity of 89% and 71%, respectively, for prediction of a CwG diagnosis.NSE may contribute to the differential diagnosis of CwG and FS associated with mild gastroenteritis.
Collapse
|
11
|
Hao XS, Liang JM, Wu XM, Hao YP, Wang JT, Liu SY. Clinical characteristics, treatment, and long-term outcomes in children suffering from benign convulsions with mild gastroenteritis: a retrospective study. BMC Pediatr 2020; 20:516. [PMID: 33172428 PMCID: PMC7656682 DOI: 10.1186/s12887-020-02406-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/26/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Benign convulsions with mild gastroenteritis (BCWG) is a common condition in children in Asia and is generally not associated with pH or electrolyte imbalances. When BCWG is diagnosed, a lumbar puncture is usually recommended to rule out potential intracranial infections. This study examined the clinical characteristics of BCWG and evaluated the necessity of lumbar puncture. METHODS Medical records of children admitted to the First Hospital of Jilin University with BCWG between January 2018 and May 2019 were reviewed and analyzed. Children were stratified by rotavirus positivity or lumbar puncture status. Clinical characteristics and long-term outcomes were compared between groups. RESULTS A total of 51 children were included in the analyses (55.1% rotavirus [HRV] positive). The average age of convulsion onset was 21.12 ± 7.44 months, the male-to-female ratio was 1.8:1, and convulsions occurred primarily between October 2018 and April 2019. The main clinical presentations of BCWG were convulsions, vomiting, diarrhea, and fever. Convulsions occurred predominantly two days after diagnosis of gastroenteritis, were mainly generalized tonic-clonic with 88.2% of children having ≤ 3 convulsions per episode, and had a mean duration of 2.0 minutes (interquartile range [IQR]: 1.0, 3.0). Children with BCWG had mild metabolic acidosis (HCO3- 17.82 ± 3.63 mmol/L) with an elevated anion gap (AG; 20.98 ± 3.00 mmol/L), mild hyponatremia (134.56 ± 2.85 mmol/L), and slightly increased levels of creatine kinase myocardial band (CKMB). HRV + children had more severe acidosis and higher CKMB levels. Cerebrospinal fluid (CSF) samples collected via lumbar puncture were normal. No developmental abnormalities were noted as assessed by the Social Life Ability Scale. CONCLUSIONS BCWG is a situation-related seizure, with clinical presentations of tonic-clonic or focal convulsions and mild gastroenteritis (vomiting, diarrhea). Mild metabolic acidosis and hyponatremia may exist. The prognosis of the disease is favorable; lumbar puncture and long-term antiepileptics are unnecessary and should not be recommended.
Collapse
Affiliation(s)
- Xiao-Sheng Hao
- The First Hospital of Jilin University, 130021, Changchun, Jilin, China
| | - Jian-Min Liang
- The First Hospital of Jilin University, 130021, Changchun, Jilin, China
| | - Xue-Mei Wu
- The First Hospital of Jilin University, 130021, Changchun, Jilin, China
| | - Yun-Peng Hao
- The First Hospital of Jilin University, 130021, Changchun, Jilin, China
| | - Jiang-Tao Wang
- The First Hospital of Jilin University, 130021, Changchun, Jilin, China.
| | - Song-Yan Liu
- The China-Japan Union Hospital, 130033, Changchun, Jilin, China.
| |
Collapse
|
12
|
Yoo SY, Kim DH, Lee Y, Lee GH, Ha DJ, Kwon YS. Serum Uric Acid as a Predictive Factor for Rotaviral or Noroviral Benign Convulsions with Mild Gastroenteritis. ANNALS OF CHILD NEUROLOGY 2020. [DOI: 10.26815/acn.2020.00143] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
13
|
Affiliation(s)
- Hans Hartmann
- Clinic for Pediatric Kidney, Liver, and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| |
Collapse
|
14
|
You SJ. Older Patients May Have More Frequent Seizures among Children Diagnosed as Benign Convulsions with Mild Gastroenteritis. Neuropediatrics 2020; 51:354-358. [PMID: 32016943 DOI: 10.1055/s-0040-1701442] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
PURPOSE Benign convulsions with mild gastroenteritis (CwG) is a condition that does not usually require treatment. However, when the patient experiences multiple seizures or prolonged seizures, anticonvulsant treatment may be required. We investigated this study to identify the factors that may influence on the number or duration of seizures at CwG. METHODS We retrospectively analyzed the medical records of CwG patients who were admitted to the Department of Pediatrics at Sanggye Paik Hospital. RESULTS A total of 105 children with CwG were enrolled. The mean age was 19.59 ± 7.09 months. The mean duration of seizure was 2.79 ± 5.51 minutes and mean number of seizure was 2.33 ± 1.70. Sixty-nine children had seizures less than twice, whereas 36 experienced three times or more. These groups differed significantly according to age in CwG (18.16 ± 7.08, vs. 22.33 ± 6.34 months, p < 0.05). When patients were divided into two groups based on age in CwG using a cut-off of 20 months, we found significant differences in seizure number (1.91 ± 1.27 vs. 3.11 ± 2.10, p < 0.05). There was also a positive correlation between patient age and frequency of seizures (R = 0.316, p = 0.001). Patients who received anticonvulsants were older (17.60 ± 6.87 vs. 22.04 ± 6.63 months, p < 0.05) and had more frequent (1.59 ± 1.37 vs. 3.26 ± 1.63, p < 0.05) and longer seizures (1.76 ± 2.75 vs. 4.07 ± 7.49 minutes, p < 0.05). CONCLUSION As the number of seizure in CwG was associated with age, treatment in older children may be required in acute stage.
Collapse
Affiliation(s)
- Su Jeong You
- Department of Pediatrics, Inje University College of Medicine, Sanggye Paik Hospital, Seoul, Korea
| |
Collapse
|
15
|
Ogawa C, Kidokoro H, Ishihara N, Tsuji T, Kurahashi H, Hattori A, Suzuki M, Ogaya S, Ito Y, Fukasawa T, Kubota T, Okumura A, Saitoh S, Natsume J. Splenial Lesions in Benign Convulsions With Gastroenteritis Associated With Rotavirus Infection. Pediatr Neurol 2020; 109:79-84. [PMID: 32303390 DOI: 10.1016/j.pediatrneurol.2019.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/28/2019] [Accepted: 05/02/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To investigate clinical risk factors for acute magnetic resonance imaging (MRI) abnormalities in patients with benign convulsions with mild gastroenteritis or benign infantile epilepsy. STUDY DESIGN 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. RESULTS 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). CONCLUSIONS 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.
Collapse
Affiliation(s)
- Chikako Ogawa
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroyuki Kidokoro
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan; Brain and Mind Research Center, Nagoya University, Nagoya, Japan
| | - Naoko Ishihara
- Department of Pediatrics, Fujita Health University, Toyoake, Japan
| | - Takeshi Tsuji
- Department of Pediatrics, Okazaki City Hospital, Okazaki, Japan
| | | | - Ayako Hattori
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Motomasa Suzuki
- Department of Neurology, Aichi Children's Health and Medical Center, Obu, Japan
| | - Shunsuke Ogaya
- Department of Pediatrics, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan
| | - Yuji Ito
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Tetsuo Kubota
- Department of Pediatrics, Anjo Kosei Hospital, Anjo, Japan
| | - Akihisa Okumura
- Department of Pediatrics, Aichi Medical University, Nagakute, Japan
| | - Shinji Saitoh
- Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Jun Natsume
- Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan; Brain and Mind Research Center, Nagoya University, Nagoya, Japan; Department of Developmental Disability Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| |
Collapse
|
16
|
Shi K, Yang J, Wu Y, Han H, Guo J, Chen W. Risk factors for the recurrence of convulsions with mild gastroenteritis in children. Seizure 2020; 80:192-195. [PMID: 32619828 DOI: 10.1016/j.seizure.2020.06.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 05/20/2020] [Accepted: 06/07/2020] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To identify risk factors for the recurrence of convulsions with mild gastroenteritis (CwG)1 in children. METHODS Altogether, 613 children with CwG admitted to Children's Hospital of Shanxi Province from January 2010 to December 2015 were selected, their clinical data were retrospectively analyzed, and patients were followed up for 4-10 years. Risk factors for the recurrence of CwG were analyzed based on the clinical characteristics of the children. RESULTS Relapse occurred in 35 patients (6.3 %). Recurrence occurred within 6 months after the first CwG in majority of the patients (80 %), and recurrence occurred once in most patients (91.4 %). Risk factors associated with CwG recurrence were age at first attack of ≤18 months (recurrence rates at ages ≤ and >18 months were 8.7 %, and 3.1 %, respectively; χ2 = 4.856, P = 0.028), and a history of convulsions in first-degree relatives (recurrence rates in first-degree relatives with and without a history of convulsion were 20 % and 6.2 %, respectively; χ2 = 5.501, P = 0.019). CONCLUSIONS Children with CwG have a possibility of recurrence. The risk of recurrence within 6 months of onset is high and such patients should be carefully observed. Furthermore, the age of onset of ≤18 months and history of convulsions in first-degree relatives are risks factors for CwG recurrence; therefore, these children should be closely followed up.
Collapse
Affiliation(s)
- Kaili Shi
- Department of Neurology, Guangzhou Women and Children's Medical Center, Guangzhou, China; Department of Neurology, Children's Hospital of Shanxi Province, Taiyuan, China.
| | - Jiehui Yang
- Department of Pediatrics, Shanxi Bethune Hospital, Taiyuan, China
| | - Yunhong Wu
- Department of Neurology, Children's Hospital of Shanxi Province, Taiyuan, China
| | - Hong Han
- Department of Neurology, Children's Hospital of Shanxi Province, Taiyuan, China
| | - Junxiu Guo
- Department of Neurology, Children's Hospital of Shanxi Province, Taiyuan, China
| | - Wenxiong Chen
- Department of Neurology, Guangzhou Women and Children's Medical Center, Guangzhou, China.
| |
Collapse
|
17
|
Kim YO. Benign Convulsions with Mild Gastroenteritis. ANNALS OF CHILD NEUROLOGY 2020. [DOI: 10.26815/acn.2019.00248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
18
|
Wu YZ, Liu YH, Tseng CM, Tseng YH, Chen TH. Comparison of Clinical Characteristics Between Febrile and Afebrile Seizures Associated With Acute Gastroenteritis in Childhood. Front Pediatr 2020; 8:167. [PMID: 32373562 PMCID: PMC7176810 DOI: 10.3389/fped.2020.00167] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 03/24/2020] [Indexed: 01/20/2023] Open
Abstract
Background: Acute gastroenteritis (AGE) accompanied by seizures is not a rare scenario in childhood. We investigated the clinical features of children with febrile or afebrile seizures during AGE and aimed to identify the impact of fever in this situation-related seizure. Methods: We retrospectively reviewed the medical charts of children admitted due to seizures associated with mild AGE between January 2008 and December 2017. These consecutive patients were divided into two groups: an "afebrile group" whose diagnosis was compatible with "benign convulsion with mild gastroenteritis (CwG)" and a "febrile group" who had a fever within 24 h of the onset of an AGE-related seizure. We compared the two groups' clinical and laboratory characteristics, electroencephalograms (EEG), neuroimaging, and outcomes. Results: Of the children suffering from AGE and seizures, 41 were afebrile and 30 were febrile, with a mean age of 32.2 ± 27.6 months. The gender, seizure semiology, frequency, duration of seizures, the time interval between AGE symptoms onset and first seizure, and levels of serum sodium, and hepatic enzymes were significantly different between the two groups. The most frequently identified enteropathogen was rotavirus (33%), especially in the male and febrile subjects. Afebrile patients had more EEG abnormalities initially, but all returned to normal later. All cases had an uneventful outcome. Of note, seizure clusters (≥2 episodes) occurred more frequently in the afebrile patients who had a duration of AGE symptoms lasting 2 days or more, or white blood cell counts ≥ 10,000/μL (p-values: 0.05 and 0.04, respectively). In comparison with seven similar studies, all showed more seizure clusters, partial seizures, and a shorter interval between AGE onset and seizures in afebrile patients than in febrile patients. Contrarily, afebrile patients had longer seizure duration and lower serum hepatic transaminases than febrile patients. Conclusion: Although fever partially influenced the clinical features of AGE-related seizures, febrile CwG might have pathophysiology distinctly different from that of febrile seizures. Comprehensive knowledge in discerning febrile and afebrile CwG can help to avoid unnecessary diagnostics tests, and anticonvulsants use.
Collapse
Affiliation(s)
- Yan-Zhang Wu
- Division of Pediatric Emergency, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yao-Hua Liu
- Department of Emergency, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chien-Ming Tseng
- Division of Pediatric Emergency, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yung-Hao Tseng
- Division of Pediatric Emergency, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Tai-Heng Chen
- Division of Pediatric Emergency, Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.,Ph.D. Program in Translational Medicine, Graduate Institute of Clinical Medicine, Kaohsiung Medical University and Academia Sinica, Kaohsiung, Taiwan.,Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| |
Collapse
|
19
|
Yoo IH, Kim W, Cho J, Kim H, Lim BC, Hwang H, Chae JH, Choi J, Kim KJ. Elevated Serum Uric Acid in Benign Convulsions with Mild Gastroenteritis in Children. J Clin Neurol 2019; 15:496-501. [PMID: 31591838 PMCID: PMC6785459 DOI: 10.3988/jcn.2019.15.4.496] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 04/26/2019] [Accepted: 04/26/2019] [Indexed: 01/04/2023] Open
Abstract
Background and Purpose To identify whether serum uric acid levels are significantly higher in patients with benign convulsion associated with mild gastroenteritis (CwG) than in patients with acute gastroenteritis. Methods This retrospective study compared the serum levels of uric acid between CwG, acute gastroenteritis, and febrile seizure after correcting for the varying degree of mild dehydration using serum HCO3− levels. We also compared the serum uric acid levels between patients with CwG and febrile seizures in order to exclude the effect of seizures on uric acid. Results This study included 154 CwG patients (age range 0.73–3.19 years), 2,938 patients with acute gastroenteritis, and 154 patients with febrile seizure. The serum uric acid level was significantly higher in CwG patients than in patients with acute gastroenteritis [9.79±2.16 mg/dL vs. 6.04±2.3 mg/dL (mean±SD), p<0.001]. This difference was also significant after correcting for dehydration. The serum uric acid level was significantly higher in CwG patients than in dehydration-corrected acute gastroenteritis patients (9.79±2.16 mg/dL vs. 6.67±2.48 mg/dL, p<0.001). The serum uric acid level was not elevated in patients with febrile seizure. Conclusions We have confirmed that serum uric acid is elevated in CwG patients even after correcting for their dehydration status, and that this was not a postictal phenomenon. Highly elevated serum uric acid in CwG could be a useful clinical indicator of CwG in patients with acute gastroenteritis.
Collapse
Affiliation(s)
- Il Han Yoo
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Pediatrics, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Woojoong Kim
- Pediatric Clinical Neuroscience Center, Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Jaeso Cho
- Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul, Korea
| | - Hunmin Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
| | - Byung Chan Lim
- Pediatric Clinical Neuroscience Center, Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Hee Hwang
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jong Hee Chae
- Pediatric Clinical Neuroscience Center, Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| | - Jieun Choi
- Department of Pediatrics, SMG-SNU Boramae Medical Center, Seoul, Korea
| | - Ki Joong Kim
- Pediatric Clinical Neuroscience Center, Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
| |
Collapse
|
20
|
Clinical features of campylobacter-associated benign convulsions with mild gastroenteritis compared with rotavirus convulsions. Seizure 2019; 70:20-24. [PMID: 31238195 DOI: 10.1016/j.seizure.2019.06.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2019] [Revised: 05/26/2019] [Accepted: 06/08/2019] [Indexed: 11/21/2022] Open
Abstract
PURPOSE The aim of the present study was to compare the clinical features of campylobacter-associated benign convulsions with mild gastroenteritis (BCWG) with rotavirus-associated BCWG in China. METHODS The medical records of BCWG patients admitted to Children's Hospital of Jiangxi Province in China between January 2015 and January 2017 were reviewed in this retrospective study. RESULTS Ultimately, 318 patients were diagnosed with BCWG. Two hundred and two cases were tested for Campylobacter jejuni antigen, and seven (3.47%) were positive. A total of 248 cases were tested for rotavirus antigen, and 44 (17.74%) were positive. Campylobacter-associated BCWG occurred in summer and autumn. In contrast, rotavirus-associated BCWG mainly occurred in winter. In the campylobacter-associated BCWG group, five patients (71.43%) had two or more seizures. In one patient(14.29%), the seizure occurred on the first day of gastroenteritis; three patients (42.86%) had seizures on the second day, and three (42.86%) had seizures on the third day or later. Thirteen seizures were observed in the campylobacter-associated BCWG group; of these, 11 (84.62%) lasted less than 5 min, and 11 (84.62%) were generalized seizures. Phenobarbital (5 mg/kg/time) was effective in all 6 cases (100%) in which it was used. Other than the different seasonal distributions, the clinical features of campylobacter-associated BCWG and rotavirus-associated BCWG may be similar. CONCLUSIONS Campylobacter is one of the pathogens responsible for BCWG, especially in summer and autumn. Other than the different seasonal distributions, the clinical features of campylobacter-associated BCWG and rotavirus-associated BCWG may be similar.
Collapse
|
21
|
Kim BR, Choi GE, Kim YO, Kim MJ, Song ES, Woo YJ. Incidence and characteristics of norovirus-associated benign convulsions with mild gastroenteritis, in comparison with rotavirus ones. Brain Dev 2018; 40:699-706. [PMID: 29681427 DOI: 10.1016/j.braindev.2018.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 04/01/2018] [Accepted: 04/03/2018] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND PURPOSE Rotavirus was detected in 40-50% of patients with benign convulsions with mild gastroenteritis (CwG) before the rotavirus vaccine was introduced in late 2000. However, the rate of rotavirus positivity has decreased since 2010 while the prevalence of norovirus has gradually increased. We investigated the incidence of norovirus-associated CwG during a recent 3-year period and additionally compared the characteristics of norovirus-associated CwG with those of rotavirus-associated CwG. METHODS The medical records of CwG patients admitted to our hospital between March 2014 and February 2017 were reviewed, including the results of stool virus tests. For comparing norovirus- and rotavirus-associated CwG, data obtained between March 2005 and February 2014 that included sufficient numbers of patients with rotavirus-associated CwG were additionally reviewed. Data were collected on clinical characteristics (age, sex, seasonal distribution, enteric symptoms, and the interval to seizure onset), seizure characteristics (frequency, duration, type, and electroencephalographic findings), and laboratory findings. RESULTS CwG was diagnosed in 42 patients during the 3-year study period. Stool viruses were checked in 40 (95.2%) patients and were detected in 32 (80.0%) patients. Norovirus genogroup II was detected in 27 (67.5%) of the 40 patients, rotavirus was detected in 3 patients, and adenovirus was detected in 2 patients. In total, 140 CwG patients were enrolled between March 2005 and February 2017. The patients with norovirus-associated CwG (N = 44) and rotavirus-associated CwG (N = 26) were aged 18.66 ± 5.57 and 19.31 ± 7.37 months (mean ± standard deviation), respectively (P > 0.05). Norovirus-associated CwG was less prevalent than rotavirus-associated CwG during spring (13.6% vs. 34.6%, P = 0.04), while the prevalence of both types of CwG peaked during winter (63.6% and 46.2%, respectively). Vomiting was more prevalent in norovirus- than rotavirus-associated CwG (97.7% vs. 80.8%, P = 0.02) and the interval between enteric symptom onset and seizure onset was shorter in norovirus-associated CwG (2.00 ± 1.06 vs. 2.58 ± 1.21 days, P = 0.04). Most cases in both groups had seizures that lasted for less than 5 min (95.5% vs. 92.3%). Clustered seizures seemed to occur more frequently in the norovirus group (79.5% vs. 57.7%), although with borderline significance (P = 0.05). Posterior slowing was observed more frequently in norovirus-associated CwG (34.9% vs. 11.5%, P = 0.03). CONCLUSION The most common viral pathogen of CwG was norovirus during the analyzed 3-year period, with an incidence of 67.5%. In comparison with rotavirus-associated CwG, norovirus-associated CwG was less frequent during spring, more frequently seen with vomiting, had a shorter interval from enteric symptom onset to seizure onset, and more frequently showed posterior slowing in electroencephalography.
Collapse
Affiliation(s)
- Bo Ram Kim
- Department of Pediatrics, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Pediatrics, Chonnam National University Childrens' Hospital, Gwangju, Republic of Korea
| | - Ga Eun Choi
- Department of Pediatrics, Chonnam National University Childrens' Hospital, Gwangju, Republic of Korea
| | - Young Ok Kim
- Department of Pediatrics, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Pediatrics, Chonnam National University Childrens' Hospital, Gwangju, Republic of Korea.
| | - Min Ji Kim
- Water and Foodborne Disease Division, Health and Environment Research Institute of Gwangju, Gwangju, Republic of Korea.
| | - Eun Song Song
- Department of Pediatrics, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Pediatrics, Chonnam National University Childrens' Hospital, Gwangju, Republic of Korea.
| | - Young Jong Woo
- Department of Pediatrics, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Pediatrics, Chonnam National University Childrens' Hospital, Gwangju, Republic of Korea.
| |
Collapse
|
22
|
Clinical outcome of recurrent afebrile seizures in children with benign convulsions associated with mild gastroenteritis. Seizure 2018; 60:110-114. [PMID: 29935410 DOI: 10.1016/j.seizure.2018.05.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 05/22/2018] [Accepted: 05/28/2018] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To assess the clinical outcome and evolution of recurrent afebrile seizures in children initially diagnosed with benign convulsions associated with mild gastroenteritis (CwG). METHODS We reviewed and analyzed the medical records of 37 patients who were diagnosed as CwG at onset, followed by recurrent afebrile seizures and followed up for at least 24 months. RESULTS The follow-up period ranged from 2 to 7 years (median, 40.1 months).Three patterns of recurrent afebrile seizures were recorded: afebrile seizures associated with gastrointestinal infection (AS-GI, n = 25), afebrile seizures associated with non-gastrointestinal infection (AS-nGI, n = 9), and unprovoked seizures (US, n = 3). Twenty eight patients (75.7%) had a second episode within 6 months after the first seizures. Five cases (13.5%) suffered three episodes of afebrile seizures. Seizure characteristics of the three patterns were similar, manifesting as clustered seizures in the majority. Focal epileptic activities in interictal EEG were found in 3 cases (9.4%) at onset, 10 cases (28.6%) at the second episode, respectively. Six patients were prescribed anti-epileptic drugs with apparently good responses. During at least 2 years' follow-up, all the cases showed normal psychomotor development. Only one patient was diagnosed with epilepsy. CONCLUSIONS All the recurrent afebrile seizures initially diagnosed as CwG, irrespective of the kinds and frequency of relapses, showed favorable prognoses. CwG maybe falls within the category of situation-related seizures, rather than epilepsy.
Collapse
|
23
|
Xue CC, Liang YF, Pan GQ, Li CC. [Benign infantile convulsions associated with mild gastroenteritis: a clinical analysis and follow-up study]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2017; 19:1191-1195. [PMID: 29132468 PMCID: PMC7389322 DOI: 10.7499/j.issn.1008-8830.2017.11.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 08/30/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To study the clinical features and prognosis of benign infantile convulsions associated with mild gastroenteritis (BICE). METHODS A retrospective analysis was performed for the clinical data of 436 children with BICE, and among these children, 206 were followed up for 1.5 to 7 years. Some parents were invited to complete the Weiss Functional Defect Scale to evaluate the long-term social function. RESULTS The peak age of onset of BICE was 13-24 months, and BICE had a higher prevalence rate in September to February of the following year. Convulsions mainly manifested as generalized tonic-clonic seizures, which often occurred within 24 hours after disease onset and lasted for less than 5 minutes each time. Sometimes they occurred in clusters. During the follow-up of 206 children, only one had epileptiform discharge, and the other children had normal electroencephalographic results. The parents of all the 206 children thought their children had normal intelligence and had no marked changes in character. Based on the Weiss Functional Defect Scale completed by the parents of some BICE children, there was no significant difference in the long-term social function between BICE children and healthy children matched by age and sex. CONCLUSIONS BICE mainly occurs in children aged 1-2 years, with the manifestation of transient generalized seizures in most children and cluster seizures in some children. BICE seldom progresses to epilepsy and has good prognosis.
Collapse
Affiliation(s)
- Chao-Chao Xue
- Department of Pediatrics, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang 325000, China.
| | | | | | | |
Collapse
|
24
|
Higuchi Y, Kubo T, Mitsuhashi T, Nakamura N, Yokota I, Komiyama O, Kamimaki I, Yamamoto S, Uchida Y, Watanabe K, Yamashita H, Tanaka S, Iguchi K, Ichimi R, Miyagawa S, Takayanagi T, Koga H, Shukuya A, Saito A, Horibe K. Clinical Epidemiology and Treatment of Febrile and Afebrile Convulsions With Mild Gastroenteritis: A Multicenter Study. Pediatr Neurol 2017; 67:78-84. [PMID: 28094168 DOI: 10.1016/j.pediatrneurol.2016.05.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/08/2016] [Revised: 05/05/2016] [Accepted: 05/21/2016] [Indexed: 12/01/2022]
Abstract
BACKGROUND We investigated features and responses to treatment in patients with febrile and afebrile convulsions with mild gastroenteritis and characterized convulsions with rotavirus and norovirus gastroenteritis. METHODS We conducted a prospective, observational study to evaluate patients with febrile and afebrile convulsions with mild gastroenteritis who were hospitalized between November 2011 and March 2014 at 13 facilities in the National Hospital Organization. We classified the patients into two groups: presence or absence of fever. We investigated the background, clinical and laboratory characteristics, viral antigen in stool, and efficacy of anticonvulsant drugs. RESULTS Of 126 patients enrolled in this study, 50 were febrile (Fc group) and 76 were afebrile (aFc group). A family history of febrile seizures was significantly more frequent in the Fc group than in the aFc group (28.0% vs 9.2%, P = 0.005). Clinical characteristics were similar between the rotavirus and norovirus groups, but fever was significantly more frequent in the rotavirus group (46.2% vs 8.3%, P < 0.001). Serum sodium levels were significantly negatively related to the number of seizures in the aFc group (β = -0.13; 95% confidence interval, -0.24, -0.03; P = 0.01). Carbamazepine was significantly more efficacious than diazepam suppositories in the aFc group (odds ratio = 49.3, 95% confidence interval, 2.35, 1037; P = 0.01). CONCLUSION Febrile convulsions with mild gastroenteritis show characteristics of both febrile seizures and convulsions with mild gastroenteritis. Carbamazepine is optimal for convulsions with mild gastroenteritis. Clinical features of convulsions with rotavirus and norovirus gastroenteritis are similar, except for fever. Serum sodium levels may play a major role in the onset of convulsions with mild gastroenteritis.
Collapse
Affiliation(s)
- Yousuke Higuchi
- Department of Pediatrics, National Hospital Organization Okayama Medical Center, Okayama, Okayama, Japan; Department of Pediatrics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, Japan
| | - Toshihide Kubo
- Department of Pediatrics, National Hospital Organization Okayama Medical Center, Okayama, Okayama, Japan.
| | - Toshiharu Mitsuhashi
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Naoko Nakamura
- Department of Pediatrics, National Hospital Organization Shikoku Medical Center for Children and Adults, Zentsuji, Kagawa, Japan
| | - Ichiro Yokota
- Department of Pediatrics, National Hospital Organization Shikoku Medical Center for Children and Adults, Zentsuji, Kagawa, Japan
| | - Osamu Komiyama
- Department of Pediatrics, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan
| | - Isamu Kamimaki
- Department of Pediatrics, Saitama National Hospital, Wako, Saitama, Japan
| | - Shigenori Yamamoto
- Department of Pediatrics, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba, Japan
| | - Yasushi Uchida
- Department of Pediatrics, National Hospital Organization Nagara Medical Center, Gifu, Gifu, Japan
| | - Kyoko Watanabe
- Department of Pediatrics, National Hospital Organization Kokura Medical Center, Kitakyushu, Fukuoka, Japan
| | - Hironori Yamashita
- Department of Pediatrics, National Hospital Organization Kokura Medical Center, Kitakyushu, Fukuoka, Japan
| | - Shigeki Tanaka
- Department of Pediatrics, National Hospital Organization Miechuo Medical Center, Tsu, Mie, Japan
| | - Kosei Iguchi
- Department of Pediatrics, Mie National Hospital, Tsu, Mie, Japan
| | - Ryouji Ichimi
- Department of Pediatrics, Mie National Hospital, Tsu, Mie, Japan
| | - Shinichiro Miyagawa
- Department of Pediatrics, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima, Japan
| | - Toshimitsu Takayanagi
- Department of Pediatrics, National Hospital Organization Saga National Hospital, Saga, Saga, Japan
| | - Hiroshi Koga
- Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Oita, Japan
| | - Akinori Shukuya
- Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Sagamihara, Kanagawa, Japan
| | - Akiko Saito
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya Clinical Research Center, Nagoya, Aichi, Japan
| | - Keizo Horibe
- Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya Clinical Research Center, Nagoya, Aichi, Japan
| |
Collapse
|
25
|
Kim GH, Byeon JH, Lee DY, Jeong HJ, Eun BL. Norovirus in benign convulsions with mild gastroenteritis. Ital J Pediatr 2016; 42:94. [PMID: 27809881 PMCID: PMC5096325 DOI: 10.1186/s13052-016-0303-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 10/15/2016] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Benign convulsions with gastroenteritis (CwG) are defined as afebrile convulsions accompanying symptoms of gastroenteritis without evidence of laboratory derangement. Although the main pathogen has been known as rotavirus, since the introduction of rotavirus vaccine, associated viruses with CwG may have changed. Thus, we evaluated the viral association of CwG for patients admitting for recent 2.5 years. METHODS All patients hospitalized for CwG between November 2012 and May 2015 were included in our study. Stool specimens were tested with reverse transcription polymerase chain reaction for detecting norovirus and astrovirus and with enzyme immunoassay for rotavirus and enteric adenovirus. Clinical data was gathered via chart review. RESULTS Fifty patients were included. Except four patients who failed to collect stool samples, 46 patients were tested. Causative diarrheal viruses were detected in 38 patients and they were 29 norovirus, four rotavirus, four adenovirus, and one astrovirus. Norovirus was commonly identified during the months of November and December. No difference of the clinical characteristics and laboratory value was noted according to the number of seizure episodes. CONCLUSIONS Norovirus is a common pathogen in CwG. Understanding the viral associations can facilitate recognition of CwG.
Collapse
Affiliation(s)
- Gun-Ha Kim
- Department of Pediatrics, Korea University College of Medicine, Seoul, South Korea
| | - Jung Hye Byeon
- Department of Pediatrics, Korea University College of Medicine, Seoul, South Korea
| | - Deog-Yong Lee
- Division of Enteric Diseases, Center for Infectious Disease, National Institute of Health, Korea Center for Disease Control & Prevention (CDC-Korea), Chungcheongbuk-do, South Korea
| | - Hyun Ju Jeong
- Division of Enteric Diseases, Center for Infectious Disease, National Institute of Health, Korea Center for Disease Control & Prevention (CDC-Korea), Chungcheongbuk-do, South Korea
| | - Baik-Lin Eun
- Department of Pediatrics, Korea University College of Medicine, Seoul, South Korea. .,Department of Pediatrics, Korea University Guro Hospital, 148, Gurodong-ro, Guro-gu, Seoul, 08308, South Korea.
| |
Collapse
|
26
|
Castellazzi L, Principi N, Agostoni C, Esposito S. Benign convulsions in children with mild gastroenteritis. Eur J Paediatr Neurol 2016; 20:690-5. [PMID: 27292317 DOI: 10.1016/j.ejpn.2016.05.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 05/19/2016] [Accepted: 05/22/2016] [Indexed: 12/20/2022]
Abstract
BACKGROUND Benign convulsions with mild gastroenteritis (CwG) is a clinical condition characterized by convulsions occurring in otherwise healthy children, usually in the absence of fever and in the presence of mild acute gastroenteritis. Until now, CwG had not been fully recognized as an epileptic syndrome, and several aspects of this condition are not clearly defined, especially its pathogenesis. METHODS The main aim of this paper is to discuss after the review of the literature what is known about CwG to facilitate its recognition and treatment. RESULTS CwG is a benign condition that has several clinical and prognostic similarities with febrile seizures. The disease occurs in infants and in children who are 1 month to 3 years old, during the winter and early spring when rotavirus and norovirus are circulating. In most cases, seizures follow gastrointestinal symptoms. In a minority of patients, the seizures and gastrointestinal symptoms occur before or simultaneously with the development of diarrhoea. Even if convulsions are mostly described as generalized tonic-clonic, the ictal recordings have always demonstrated a focal origin. Electroencephalography, lumbar punctures, and radiological examinations are not useful because they are normal in these patients; and when alterations are present, they disappear in a relatively short time. Only prolonged seizures, which are usually not common, require antiepileptic treatments in the acute phase. CONCLUSION Knowledge of CwG characteristics is essential for paediatricians to avoid useless hospitalization, examinations and, above all, drug administration, as the drugs have potential side effects.
Collapse
Affiliation(s)
- Luca Castellazzi
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Nicola Principi
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Agostoni
- Pediatric Medium Intensity Care Unit, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Susanna Esposito
- Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
| |
Collapse
|
27
|
Nakazawa M, Toda S, Abe S, Ikeno M, Igarashi A, Nakahara E, Yamashita S, Niijima S, Shimizu T, Okumura A. Efficacy and safety of fosphenytoin for benign convulsions with mild gastroenteritis. Brain Dev 2015; 37:864-7. [PMID: 25708686 DOI: 10.1016/j.braindev.2015.02.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2014] [Revised: 02/03/2015] [Accepted: 02/04/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To clarify the efficacy and safety of fosphenytoin for seizures in children with benign convulsions and mild gastroenteritis. METHODS Using the mailing list of the Annual Zao Conference on Pediatric Neurology, we recruited patients who met the following criteria: (1) clinical diagnosis of benign convulsions with mild gastroenteritis and (2) treatment with intravenous fosphenytoin. Benign convulsions with mild gastroenteritis were defined as a condition of (a) seizures associated with gastroenteritis without electrolyte imbalance, hypoglycemia, or dehydration in patients (b) between 6 months and 3 years of age with (c) no preexisting neurological disorders, (d) no impaired consciousness, and (e) a body temperature less than 38.0 °C before and after the seizures. The efficacy of fosphenytoin was categorized as effective when cessation of seizures was achieved. RESULTS Data from 16 child patients were obtained (median age, 20 months). Seizures were completely controlled after the initial dose of fosphenytoin in 14 of 16 patients. The median loading dose of fosphenytoin was 22.5 mg/kg. In 10 patients, fosphenytoin was administered after other antiepileptic drugs such as diazepam and midazolam were used. Adverse effects of fosphenytoin, excessive sedation, or intravenous fluid incompatibility were not observed in any patients. CONCLUSION Fosphenytoin is effective and well tolerated among children with benign convulsions with mild gastroenteritis.
Collapse
Affiliation(s)
- Mika Nakazawa
- Department of Pediatrics, Juntendo University Faculty of Medicine, Japan.
| | - Soichiro Toda
- Department of Pediatrics, Kameda Medical Center, Japan
| | - Shinpei Abe
- Department of Pediatrics, Juntendo University Faculty of Medicine, Japan
| | - Mitsuru Ikeno
- Department of Pediatrics, Juntendo University Faculty of Medicine, Japan
| | - Ayuko Igarashi
- Department of Pediatrics, Juntendo University Faculty of Medicine, Japan
| | - Eri Nakahara
- Department of Pediatrics, Juntendo University Faculty of Medicine, Japan
| | | | - Shinichi Niijima
- Department of Pediatrics, Juntendo University Nerima Hospital, Japan
| | - Toshiaki Shimizu
- Department of Pediatrics, Juntendo University Faculty of Medicine, Japan
| | - Akihisa Okumura
- Department of Pediatrics, Juntendo University Faculty of Medicine, Japan; Department of Pediatrics, Aichi Medical University, Japan
| |
Collapse
|
28
|
Park SH, Kim YO, Kim HK, Kim HS, Kim BY, Cheon KR, Kim MJ, Kim SH, Chung JK, Woo YJ. Incidence of benign convulsions with mild gastroenteritis after introduction of rotavirus vaccine. Brain Dev 2015; 37:625-30. [PMID: 25266417 DOI: 10.1016/j.braindev.2014.09.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 08/29/2014] [Accepted: 09/07/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND PURPOSE Rotavirus was the most common virus in benign convulsions with mild gastroenteritis (CwG), with an incidence of 40-50%. As rotavirus gastroenteritis has decreased since introduction of rotavirus vaccine, we investigated the incidence of CwG and rotavirus positivity after introduction of the vaccine. METHODS We retrospectively reviewed the medical records of 987 patients aged between 3months and 3years who were admitted to the Chonnam National University Hospital between March 2005 and February 2014 due to their first seizures and enrolled 102 patients with CwG. The incidences of CwG among seizure patients and stool rotavirus positivity in CwG patients were compared between two periods: period I (March 2005-February 2010) and period II (March 2010-February 2014). Other viruses in stools were also reviewed. RESULTS The incidence of CwG were 8.47% (45 among 531 patients) in period I and 12.50% (57 among 456 patients) in period II (P=0.018). Stool rotavirus was checked in 85.29% (87 patients): 82.22% (37 patients) in period I and 87.72% (50 patients) in period II (P=0.166). The positivity of rotavirus was 40.54% (15 patients) in period I and 16.00% (8 patients) in period II (P=0.01). In the patients without rotavirus gastroenteritis, 30 patients were test for other viruses. Norovirus was the most common (56.67%, 17 patients) and was more frequent in period II than I (71.43% versus 22.22%, P=0.018). CONCLUSION After introduction of rotavirus vaccine, rotavirus-associated CwG has decreased but the incidence of CwG has increased due to an increase of norovirus.
Collapse
Affiliation(s)
- Sang Hyun Park
- Department of Pediatrics, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Pediatrics, Chonanm National University Hospital, Gwangju, Republic of Korea
| | - Young Ok Kim
- Department of Pediatrics, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Pediatrics, Chonanm National University Hospital, Gwangju, Republic of Korea.
| | - Han Kyul Kim
- Department of Pediatrics, Chonanm National University Hospital, Gwangju, Republic of Korea
| | - Ho Sung Kim
- Department of Pediatrics, Chonanm National University Hospital, Gwangju, Republic of Korea
| | - Byoung Young Kim
- Department of Pediatrics, Chonanm National University Hospital, Gwangju, Republic of Korea
| | - Kyeong Ryeol Cheon
- Department of Pediatrics, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Pediatrics, Chonanm National University Hospital, Gwangju, Republic of Korea
| | - Min Ji Kim
- Health and Environment Institute of Gwangju, Gwangju, Republic of Korea
| | - Sun Hee Kim
- Health and Environment Institute of Gwangju, Gwangju, Republic of Korea
| | - Jae Keun Chung
- Health and Environment Institute of Gwangju, Gwangju, Republic of Korea
| | - Young Jong Woo
- Department of Pediatrics, Chonnam National University Medical School, Gwangju, Republic of Korea; Department of Pediatrics, Chonanm National University Hospital, Gwangju, Republic of Korea
| |
Collapse
|