轻度胃肠炎伴良性婴幼儿惊厥36例临床分析

Clinical analysis of mild gastroenteritis associated with benign infantile convulsions in 36 cases

目的探讨轻度胃肠炎伴良性婴幼儿惊厥(BICE)的临床特征及脑电图特点。方法收集本科2011年1～12月诊断为BICE的患儿36例,回顾性分析其临床及脑电图特征。结果病例于秋冬季节多发,其他季节散发;患儿胃肠道症状不重;27例惊厥出现于胃肠道症状出现后2d内,8例出现于胃肠道症状出现后3～5d,1例出现于胃肠道症状之前,34例惊厥表现为为强直-阵挛发作,2例表现为部分发作泛化全身,31例仅发作1次,5例反复发作2～4次;脑脊液、血生化及头颅影像学检查未见明显异常;发作缓解后24h内脑电图:25例未见异常,11例可见痫样放电,多为中央区、顶区散发棘波,其中2例背景区偶发全导慢波,72h后复查脑电图:10例恢复正常,1例仍可见散发棘波放电;随访半年35例患儿预后良好,仅1例发展为癫痫。结论本病胃肠道症状不重;惊厥多出现为胃肠道症状出现后48h内;惊厥发作表现形式多为全身性发作,且多数患儿仅发作1次;脑电图检查多无痫样放电;多数病例预后良好。

Objective To explore the clinical and EEG characteristics of benign infantile convulsions with mild gas- troenteritis （BICE）. Methods Collected 36 cases of children in our department from January 2011 to December 2011 who were diagnosis of this disease and analyzed their clinical and EEG features retrospectively. Results The incidence was significantly increased in autumn and winter, and disseminated in other seasons. The gastroenteritis symptoms of the 36 children were mild. 27 cases of convulsions occurred at the emergence of the gastrointestinal symptoms within 2 days, 8 cases occurred after 3-5 days when gastrointestinal symptoms appeared, and 1 case occured before gastroin- testinal symptoms. 34 cases of the convulsions manifestations generalized tonic-clonic seizures, 2 cases showed partial seizures secondarily generalized seizures. The number of seizures of 31 cases in the course of the disease was only once; and the number of seizures of 5 cases was 2-4 times. There were no obvious abnormal findings in CSF, blood biochemistry and cerebral imaging examinations. The EEG manifestations within 24 hours after seizures： 25 cases were normal, but 11 cases showed epileptiform discharges. The most EEG discharges were sharp spikes in central and pari- etal regions, in which 2 cases of background showed accidental slow-waves throughout all leads. The EEG reexamina- tions after 72 hours： 10 cases recovered normal, but 1 case still showed sharp spikes. In a 6 months follow-up, 35 cases of prognosis was good, but 1 case developed epilepsy. Conclusion The gastroenteritis symptoms of BICE were mild. The seizures occurred mostly within 48 hours after the gastrointestinal symptoms. Manifestations of seizures mostly generalized general seizures, and the most number of seizures was only once. Most EEG manifestations were normal. Most of children with BICE had a good prognosis.