轮状病毒肠炎伴良性婴幼儿惊厥23例临床分析

Clinical study on 23 cases of rotavirus gastroenteritis with benign infantile convulsions

目的分析轮状病毒肠炎伴良性婴幼儿惊厥的临床特点。方法对我院收治的23例轮状病毒肠炎伴惊厥患儿进行临床观察和随访。结果23例患儿发病年龄(13．8±6．4)个月,3 d内发生惊厥者19例,均为全身性发作,持续时间短,不超过5 min,一次病程中平均发作次数1．7次。多数病例不复发,部分可复发,病程＜1年。惊厥停止后未行抗癫痫治疗。发作间期脑电图正常,血生化、脑脊液、脑CT等检查正常。全部病例无癫痫和热性惊厥家族史,精神运动发育正常。结论本组病例具有以下特点：(1)1～2岁高发,冬春季多见,婴幼儿既往体健,无家族史；(2)惊厥于病程1～5 d发作,1～3 d多见,惊厥多发生于玩耍过程中,全身性发作为主,无脱水及酸中毒；(3)血生化、脑脊液、脑CT和发作间期脑电图均正常；(4)多数病例不复发,部分可复发,病程＜1年,预后好。

Objective To study the clinical features of rotavirus gastroenteritis with benign infantile convulsion. Methods A total of 23 infants with rotavirus gastroenteritis accompanied by convulsion who were treated in our hospital from January 2001 to April 2004 were observed and followed up. Results The age of onset in the 23 cases was （13.8±6.4） months. The seizure occurred in first 3 d of an episode in 19 cases. The pattern of seizure was generalization in 100%, with short lasting time, less than 5 min. The average number of seizures during a single episode was 1.7. No antiepileptic treatment was given to all as the seizures stopped. Relapse occurred in only a few patients during the follow up, with an episode less than 1 year. All displayed normal EEG background in interictal period. The results of serum biochemistry and cerebrospinal fluid （CSF） and CT scan were normal. All patients had no family history of convulsions or epilepsy and had normal psychomotor development before and after onset. Conclusion The cases have the following characteristics： （1）the prevailing age is 1 to 2 years old, the season is winter or spring, and infants have good health, without family history; （2）the convulsions all occur in first 5 d during an episode, most of which occur in the fist 3 d, while infants play; most are generalization, without dehydration and acidosis; （3）test of serum biochemistry, CSF, CT scans and interictal EEG are normal; （4）only a few patients may relapse, but the course is less than 1 year, and with good prognosis.