轻度胃肠炎伴良性婴幼儿惊厥的临床研究(英文)

Clinical features of benign infantile convulsions associated with mild gastroenteritis

摘要:

目的：认识轻度胃肠炎伴良性婴幼儿惊厥(BICE)的临床特点,做到正确诊断和合理治疗。方法：对年龄在3～36个月的轻度胃肠炎伴惊厥的患儿进行临床观察和出院后18个月以上的随访。结果：12例诊断为BICE,发病年龄(16.0±6.5)个月,6例(50%)冬季发病,9例(75%)3d内发生惊厥,为全身性或部分性发作,7例(58%)有早期频繁发作,一次病程中惊厥平均发作2.1次。发作间期EEG、脑影像学、血生化及脑脊液检查正常。惊厥停止后未行抗痫治疗,3例(25%)复发,复发≤2次,病程最长为8个月。所有病例精神运动发育正常。结论：本组BICE具有以下特点:1～2岁高发,冬季多发,无家族史;无热惊厥多出现于病程的早期,全身性或部分性发作,早期频繁发作多见;血电解质、血生化、脑脊液、脑影像学和发作间期脑电图正常;部分病例可复发,病程少于1年,预后好。惊厥停止后不推荐应用抗癫痫药。

Abstract:

OBJECTIVE: The aim of the study was to investigate the clinical features of benign infantile convulsions associated with mild gastroenteritis (BICE) and provide helpful information for the accurate diagnosis and effective management of BICE. METHODS: The patients, aged 3-36 months, with gastroenteritis accompanied with convulsions were clinically observed and followed up for more than 18 months. RESULTS: BICE was diagnosed in 12 cases with a peak onset age of (16.0 ± 6.5) months. Six (50%) of the cases occurred in winter. All seizures developed within the first 5 days of the course and 9 (75%) within the first 3 days. The cases presented with generalized or partial seizures. Early clustering seizure attacks were seen in 7 patients (58%). Seizures averaged 2.1 attacks per course. Interictal electroencephalogram (EEG), brain imaging, blood biochemical profile and cerebrospinal fluid (CSF) testing did not show abnormality in all cases. No antiepileptic medications were prescribed to the patients as the seizures had stopped. Three (25%) of the cases experienced relapses that usually did not happen more than twice. The longest course of BICE lasted 8 months. All cases demonstrated normal psychomotor development and had no individual or family history of febrile convulsion or epilepsy. CONCLUSIONS: In this study BICE showed the following clinical features: It occurred at a peak age of 1 to 2 years old and was frequently seen in wintertime. The convulsions usually developed in early days of the course in generalized or partial and mostly in clustering patterns. There were no significant changes in blood biochemical profile, CSF, brain imaging and interictal EEG. The course usually lasted less than 12 months although a small portion of the patients relapsed. An anti-epileptic therapy may not be necessary after seizure cessation in children with BICE.