轻度胃肠炎伴婴幼儿良性惊厥48例临床分析与随访

Clinical analysis and follow up on 48 cases of benign convulsions associated with mild gastroenteritis

目的 分析轻度胃肠炎伴婴幼儿良性惊厥（BICE）的临床特点及预后;方法 对2013年1月-2016年2月住院治疗的轻度胃肠炎伴婴幼儿良性惊厥患儿48例进行临床观察,收集患儿年龄、性别、惊厥发生年龄、出现时间、发生频率、持续时间、发作类型、首发时脑电图特点、家族史、影像学特点等数据,病愈后进行2～39个月随访,回顾分析其临床特点及预后。结果 在48例患儿中年龄最小5个月,最大33个月;男女比例5∶7;腹泻1d出现惊厥者11例,腹泻2d出现惊厥者9例,腹泻3d以上出现惊厥者28例;腹泻后仅有1次惊厥者32例,2次惊厥者10例,3次以上惊厥者6例;惊厥持续时间小于5min者34例,持续5min以上者14例;48例患儿中38例为全面性发作,10例为局灶性发作。惊厥发作1周内脑电图异常者15例;48例患儿中7例有惊厥家族史;影像学检查中7例存在异常,余41例未见异常。随访6例复发,占12.50%,其中脑电图异常者5例,考虑诊断癫痫。结论 轻度胃肠炎伴婴幼儿良性惊厥患儿多数预后良好,但少数存在复发,初期脑电图异常可能为高危因素,需长期随访观察。

Objective To explore the clinical characteristics and prognosis in patients of benign convulsions associated with mild gastroenteritis（BICE）. Methods The clinical manifestation of 48 patients were evaluated who hospitalized from January 2013 to February 2016,and then followed for 2～39 months. Results The age of onset was minimum 5 months, maximum 33 months respectively,the ratio of male to female was 5 ： 7. Convulsions occurred in 11 patients on the first day, 9 patients on the second day and 28 patients on the third to seventh day. Convulsion occured in 34 cases for less than 5 mi- nutes, 14 cases for more than 5 minutes. In children with 48 cases,38 children had generalised seizures and 10 had partial sei- zures. The interctal EEG was abnormal in 15 patients. 7 cases had family history of convulsion. 7 cases had abnormal imaging examination. During the follow up,6 cases （12.50 %）sufered from recurrence of seizure, 5 of them had abnormal EEG and diagnosed as epilepsy. Conclusion Prognosis can have a good effect on patients with BICE,but a few have the risk of recurrence,the abnormal EEG might be the high risk factor,which is necessary for the children to follow up.