Una causa infrecuente de convulsión afebril: gastroenteritis por rotavirus / A rare cause of afebrile convulsion: rotavirus gastroenteritis

La gastroenteritis por rotavirus es la más frecuente de las diarreas infecciosas y ocasiona una importante morbimortalidad en los niños pequeños, además de deshidratación grave y desequilibrios electrolíticos; los signos extraintestinales son infrecuentes. Recientemente se han comunicado convulsiones afebriles asociadas con gastroenteritis por rotavirus, sin encefalopatía, deshidratación, desequilibrio electrolítico o hipoglucemia. Comunicamos el caso de un paciente con convulsiones durante una gastroenteritis por rotavirus, una infección habitual en nuestro país (Turquía), con diversas manifestaciones clínicas, entre ellas, las convulsiones, que pueden verse no sólo en los niños con enfermedades neurológicas o sistémicas sino también en los niños sanos.

Rotavirus is the most common infectious diarrhea that causes important mortality and morbidities in small children, severe dehydration and electrolyte imbalance. Extraintestinal signs are rare in rotavirus infections. Recently, afebrile seizures associated with rotavirus gastroenteritis but without encephalopathy, dehydration, electrolyte imbalance or hypoglycemia have being reported. In this article, the fact that rotavirus, which is seen commonly in our country, can be confronted with various clinical manifestations was emphasized by reminding that it can be seen not only in infants with neurologic and systemic disease but also in healthy infants.

Afebrile Convulsion Associated with Rotaviral Gastroenteritis in Childhood

Rotavirus is an important pathogen of acute infantile gastroenteritis as well as is suspected of being one of the causative agents of benign convulsion. We evaluated the clinical and laboratory features noted in 9 young children with Rotazyme positive gastroenteritis and afebrile seizure retrospectly. Seventy-seven patients were admitted to the department of pediatrics in Yeungnam University Hospital with a history of Rotazyme positive gastroenteritis between January 1, 1991 and June 30, 1993. Afebrile convulsions have been noted in 9(11.6%) of them (7 boys and 2 girls). Their age ranged from 13 to 36 months. The seizure episodes ranged from 1 to 6 time in cluster within 2 hours. The seizure were all generalized tonic-clonic seizures lasting 1-5minutes. Serum electrolyte, EEG, brain CT and CSF findings were normal except a mild pleocytosis in one patient. Any type of epilepsy was not occurred and psychomotor development was normal in 7 patients who were followed up for 6-44 months Afebrile convulsions are sometimes found in patients with rotavirus gastroenteritis. They are characterized by brief generalized seizure or seizures in cluster, normal laboratory findings and good prognosis. We believe that individualized approach is needed in the management of rotavirus gastroenteritis with afebrile convulsion.