轻度胃肠炎伴婴幼儿良性惊厥56例临床特点与随访分析

Clinical characteristics and follow-up of 56 children with benign infantile convulsions with mild gastroenteritis

目的探讨轻度婴幼儿胃肠炎伴良性惊厥(BICE)的临床特点及预后。方法回顾性分析56例BICE患儿的一般资料、临床特点及随访情况等。结果56例BICE患儿发病年龄以12~36个月常见(占92.9%),发病季节以秋冬季常见(占87.5%)。37.5%患儿大便轮状病毒检测阳性。惊厥发生在病程的第0~4日,持续时间10 s^10 min,常表现为全身强直-阵挛发作。82.1%患儿无发热,17.9%患儿有低热,病程中惊厥反复发作倾向性强。26.8%患儿惊厥前无典型腹泻症状。所有患儿均无重度脱水或酸碱失衡及电解质紊乱表现。仅2例患儿急性期的脑电图存在异常,1个月后复查正常。随访时间6个月~5.5年,2例患儿曾再次出现惊厥,诊断为热性惊厥。1例患儿自出生后即存在生长发育缓慢,其余患儿生长发育评估未见明显异常。结论BICE多发生在中枢神经系统发育不成熟的婴幼儿,轮状病毒感染是其重要的诱因,临床预后普遍良好。

Objective To summarize the clinical characteristics and clinical prognosis of children with benign infantile convulsions with mild gastroenteritis(BICE).Methods The demographic data,clinical characteristics,and follow-up of 56 BICE children were retrospectively analyzed.Results The most common age of onset of BICE children was 12-36 months,accounting for 92.9%(52/56).Autumn and winter were the most frequent seasons of onset(87.5%).The stool samples of 37.5%(21/56)children were positive for rotavirus.Convulsions occurred on day 0-4 of the disease course,lasted from 10 seconds to 10 minutes,mainly manifested as generalized tonic-clonic seizures.A majority of children(82.1%)had no fever,and 17.9%presented with low fever.The tendency of recurrent seizures was high.Among them,26.8%(15/56)of the children presented with no typical diarrhea symptoms before convulsions.All children experienced no acidbase imbalance or electrolyte disorder.Two children had abnormal EEG in acute stage,which were restored normal after 1 month.During the follow-up from 6 months to 5.5 years,two children presented with recurrent convulsions,who were diagnosed with febrile convulsions.One case experienced slow development since birth,and other cases had no obvious abnormality in development evaluation.Conclusions BICE primarily occurs in infants with immature central nervous system.Rotavirus infection is an important inducement,and the clinical prognosis is generally good.