轻度胃肠炎伴婴幼儿良性惊厥的临床分析及随访研究

Benign infantile convulsions associated with mild gastroenteritis:a clinical analysis and follow-up study

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436例BICE患儿的临床资料进行回顾性分析,并对其中206例患儿进行1.5~7年的预后随访,邀请部分家长完成Weiss功能缺陷量表以评价患儿远期的社会功能。结果患儿发病年龄多在13~24月龄;发病时间多在9月至次年2月;惊厥主要表现为全身强直-阵挛发作,多在发病24 h内发作,每次持续时间多在5 min内,可有丛集性发作。206例患儿随访过程中,除1例仍有癎样放电,其余脑电图复查均恢复正常,所有患儿家属认为患儿智力正常,无明显性格改变。基于部分BICE患儿家长填写的Weiss功能缺陷量表显示,BICE患儿的远期社会功能与年龄、性别相匹配的健康对照儿童比较差异无统计学意义。结论 BICE多发生于1~2岁婴幼儿,多表现为短暂的全面性发作,部分可表现为丛集性发作,但极少进展为癫癎,预后良好。

Objective To study the clinical features and prognosis of benign infantile convulsions associated with mild gastroenteritis（BICE）.Methods A retrospective analysis was performed for the clinical data of 436 children with BICE,and among these children,206 were followed up for 1.5 to 7 years.Some parents were invited to complete the Weiss Functional Defect Scale to evaluate the long-term social function.Results The peak age of onset of BICE was 13-24 months,and BICE had a higher prevalence rate in September to February of the following year.Convulsions mainly manifested as generalized tonic-clonic seizures,which often occurred within 24 hours after disease onset and lasted for less than 5 minutes each time.Sometimes they occurred in clusters.During the follow-up of 206 children,only one had epileptiform discharge,and the other children had normal electroencephalographic results.The parents of all the 206 children thought their children had normal intelligence and had no marked changes in character.Based on the Weiss Functional Defect Scale completed by the parents of some BICE children,there was no significant difference in the longterm social function between BICE children and healthy children matched by age and sex.Conclusions BICE mainly occurs in children aged 1-2 years,with the manifestation of transient generalized seizures in most children and cluster seizures in some children.BICE seldom progresses to epilepsy and has good prognosis.