轮状病毒肠炎并发无热惊厥22例临床分析

Clinical Anlysis of 22 Cases of Afebrile Convulsion following Rotavirus Enteritis

目的 :分析小儿轮状病毒肠炎并发无热惊厥的住院病人的临床特点 ,并评价其近期预后。方法 :回顾分析上海儿童医学中心 1998～ 2 0 0 4年治疗的 2 2例轮状病毒肠炎并发无热惊厥的住院病人的临床特点。所有病人既往无惊厥史。结果 :确诊为轮状病毒肠炎的共 30 6例 ,其中 34例伴有惊厥发生 ,包括 2 2例无热惊厥和 12例高热惊厥。并发无热惊厥的 2 2例中 ,男13例 ,女 9例 ,年龄范围为 4个月～ 5 .4岁 ,平均年龄 19个月。无热惊厥发生率最高的年龄段为 1～ 2岁。有 9例在 1次病程中发生多次无热惊厥 ,占 4 0 .9%。无一例为惊厥持续状态。共 12例接受脑脊液检查均正常。仅 2例在急性期发现脑电图轻度异常 ,恢复期复查转为正常。除发现 1例存在严重低血糖外 ,其余病例均无明显的电解质紊乱。 1例头颅CT提示脑沟、脑池增宽 ,脑室扩大 ,其余病例无影像学异常发现。随访期中所有病人均未再发生惊厥。结论 :在轮状病毒肠炎病程中并发无热惊厥的病例大多数为一个良性的过程 ,预后较好。

Objective: To analyse the clinical manifestations of hospitalized children with afebrile convulsion following rotavirus enteritis and evaluate their short-term outcomes. Methods: We conducted a retrospective study enrolling the pediatric patients with the diagnosis of rotavirus enteritis during the recent 6 years. No patient had previous seizure history. The statistical method used was Chi-square test. Results: Among 34 cases of convulsion, 22 was identified as afebrile convulsion, including 13 boys and 9 girls. The age of the patients ranged from 4 months to 5.4 years old (mean 19 months). The highest incidence of afebrile convulsion was observed in children of 1 to 2 years old. 9 had two or more seizures during the illness. No cases of status epilepticus. Cerebrospinal fluid examination was performed in 12 patients without any abnormal findings. Only 2 of all had abnormal EEG findings, which turned to normal during the convalescent stage. No electrolyte disorders were observed except one case of severe hypoglycemia. No abnormal findings of intracranial image were observed except one case of head CT scan showed enlarged ventricles. No one had convulsions during the follow-up period. Conclusion:The course of afebrile convulsion following rotavirus enteritis revealed to be relatively benign.