A Clinical Study of Benign Convulsions Associated with Acute Gastroenteritis / 대한소아신경학회지

PURPOSE: The aim of this study was to reveal detailed clinical features of benign childhood convulsions associated with acute gastroenteritis(BCAGE). METHODS: The medical records of 28 patients with BCAGE, who were admitted to the department of pediatrics, Chonnam National University Hospital between March 2000 and October 2004, were reviewed on the aspects of clinical symptoms, diagnostic tests and treatment. RESULTS: The ages of the subjects cases ranged from one to 96 months old and most of them had BCAGE in late autumn and winter seasons. Seizures were developed mostly 2 to 4 days after the symptoms of gastroenteritis appeared. Most of them showed generalized seizures which occurred repetitively during the episode of acute gastroenteritis (mean 2.7+/-0.9 times of the seizures attack), mostly 2-4 times. The duration of seizure was largely below 5 minutes, but in 2 cases it was prolonged over 15 minutes. The Rotazyme tests of stool were positive only in 3 cases(16.7%), and the cerebrospinal fluid and blood examinations revealed normal results. Either brain CT or MRI was performed in 17 patients and variable results were demonstrated. Most of them showed normal or mild brain swelling, but one showed cortical dysplasia of the frontal and parietal lobes, while another one showed cerebrospinal fluid collection in the posterior fossa. 17 patients were treated with diazepam, 12 of whom were prescribed additional phenbarbital or phenytoin. 2 patients who did not take diazepam were administered antiepileptics. Antiepileptic drugs were continuously given to 4 patients for up to one year after discharged from hospital. During follow-up periods, there occurred no further seizures in all the patients. CONCLUSION: BCAGE can be considered as a situation related seizure which does not need any long-term antiepileptic medications.

Clinical Investigation of Benign Afebrile Seizure with Gastroenteritis / 대한소아신경학회지

PURPOSE: The aim of this study is to characterize detailed clinical features of benign afebrile seizure with gastroenteritis. METHODS: We retrospectively investigated the medical records of 52 patients with benign afebrile seizure and gastroenteritis, who were admitted to the Department of Pediatrics Eulji University Hospital, between February 1996 and January 2005. RESULTS: There were 52 patients with benign afebrile seizure and gastroenteritis:18 boys and 34 girls. Most of the patients(86.5%) were from 12 to 23 months of age. In the monthly distribution, 71.1% were admitted between November and March. Most of the seizures(98.0%) were generalized and 53.9% of those were generalized tonic and clonic. The durations of the seizures were mostly within 5 minutes. 40 patients(76.9%) had 2 or more seizures. The interval between the onset of gastroenteritis and seizures was mostly from 2 to 4 days. Fifteen out of 32 patients were rotazyme positive. Chi-square test was performed to identify if there was any association between rotavirus and afebrile seizure. Rotavirus gastroenteritis has a stastically significant association with afebrile seizure compared to non-rotavirus gastroenteritis(P<0.01). The relative risk between rotavirus and non-rotavirus gastroenteritis was 3.35. However, there were no significant differences in clinical features between two groups. Cerebrospinal fluid was normal and cell counts, glucose and protein levels in all the patients examined. Either brain CT or MRI was performed in 9 patients and demonstrated no neuroradiological abnormalities. Electroencephalography was performed in 47 patients, of whom 43 patients(92.3%) showed normal electroencephalographic patterns. CONCLUSION: Benign afebrile seizure is characterized by the onset age between 12 months and 23 months, multiple episodes of seizure, short duration, generalized type, high incidence between November and March, and rotavirus as a major pathogen.

A Cilinical Study of Diarrhea-Associated Benign Infantile Convulsion / 대한소아신경학회지

PURPOSE: The aim of this study is to reveal the detailed clinical features of diarrhea- associated benign infantile convulsion. METHODS: We studied 34 patients with diarrhea-associated benign infantile convulsion between March 2000 and February 2004. RESULTS: There were 34 patients with diarrhea-associated benign infantile convulsion : 19 boys and 15 girls. The age of the disease onset ranged from 3 to 34(mean; 18.7+/-6.6) months. The incidence was high from November to March. The types of the seizures were generalized tonic-clonic or generalized tonic in 32(94%) of 34 episodes, while the seizure types changed during episodes for 2 patients. The durations of seizures were from 3 sec to 10 min. 2 or more seizures occurred in 22(64.7%) episodes. A family history of febrile or afebrile convulsions was noted in 3 patients. There were no abnormalities in serum biochemistry tests. 12 out of 22 patients showed positive rotavirus antigen tests. Interictal EEG's were normal in 26 out of 30 episodes. CT or MRI demonstrated no neuroradiological abnormalities in 13 out of 14 patients. 4 patients experienced recurrence of diarrhea-associated benign infantile convulsion, but none had more than 2 episodes. Epilepsy developed in none of the patients during the follow-up period. CONCLUSION: Diarrhea-associated benign infantile convulsion is characterized by a cluster of seizures. A continous or intermittent antiepileptic treatment is not required because recurrence or later development of epilepsy is rare. Appropriate treatment for a cluster of seizures will be the subject of future studies.