轻度胃肠炎伴婴幼儿良性惊厥的临床特征分析

Clinical characteristics of benign infantile convulsions cases with mild gastroenteritis

目的总结轻度胃肠炎伴婴幼儿良性惊厥（BICE）的临床特征。方法本院2003—01～2007—12诊断BICE患儿17例，结合文献报道的299例共316例进行回顾性分析。结果BICE发病的高峰年龄为13～24个月（68．42％），平均年龄14～16个月。以秋冬季发病最多（75．75％）。惊厥症状绝大部分出现在消化道症状后的1～3d（87．59％），其中又以第2天最多见（47．37％）；病程中以惊厥发生1～2次最多见（83．55％）；90．19％的惊厥发作形式为全身强直一阵挛发作。140例患儿中，大便轮状病毒检测阳性74例（52．86％）；150例脑脊液检查均正常；常规脑电图示93．13％未见异常；头颅CT或MRI检查示98．85％均未见异常。初次惊厥发作后，经抗惊厥治疗，83．33％惊厥得到控制；2次惊厥发作者，治疗后又有70．37％不再发作。结论轮状病毒感染是导致BICE的一个主要原因；绝大部分患儿抗惊厥治疗有效，惊厥容易控制，不需长期抗癫痫治疗；预后良好，随访中95．12％无复发，精神运动及智力发育正常。

Objective To analyze the clinical characteristics of benign infantile convulsions cases with mild gastroenteritis （BICE）. Methods 316 eases of BICE including 17 cases diagnosed in China- Japan Friendship Hospital from January 2003 to December 2007 and 299 cases from literature were retrospectively analyzed. Results The peak age of BICE onset was from 13 months to 24 months （ average 14 - 16 months）. 75.75% of eases occurred in autumn or winter. The seizure occurred mostly on the first 3 day of an episode （87.59%） and was more common on the second day （47.37%）. In 83.55% of cases, the number of seizures was 1 to 2 and most cases （90.19%） had general seizures. The detection of rotavirus in the stools was positive in 74 of the 140 cases （52.86%）. No significant change was found in cerebrospinal fluid examination of 150 cases, routine EEG in 93.13% of cases and cranial CT or MRI in 98.85% of cases during the attack. Convulsions did not recur in 83.33% of children with first attack and in 70.37% of cases with second attack after anticonvulsant therapy. Conclusions Rotavirus infection is a major cause of BICE. The seizures are easy to be controlled in most cases with BICE, which indicate longterm anticonvulsant therapy is not usually warranted. Most cases （95.12%） didn＇t have relapse during the follow up period and the children with BICE have good prognosis.