婴幼儿轻度胃肠炎伴良性惊厥并发可逆性胼胝体压部病变综合征临床特征

Clinical characteristics of reversible splenial lesion syndrome in infants with mild gastroenteritis and benign convulsions

目的探讨婴幼儿轻度胃肠炎伴良性惊厥(CwG)并发可逆性胼胝体压部病变综合征(RESLES)的临床特征。方法收集2010年1月至2019年1月收治住院的婴幼儿CwG,依据头颅MRI符合RESLES的患儿77例,其中单纯CwG组69例,CwG并发RESLES组(胼胝体病变组)8例。比较分析患儿一般情况、家族史、临床表现及预后情况。结果胼胝体病变组单次惊厥时间>5 min发生率明显高于单纯CwG组(62.5%vs 17.4%,χ^2=6.060,P=0.014)。出院6个月随访时,单纯CwG组失访4例,胼胝体病变组惊厥再发率为12.5%(1/8),与单纯CwG组的13.8%(9/65)比较差异无统计学意义(P>0.05)。结论婴幼儿CwG并发的胼胝体压部病变多表现为孤立性病变,临床表现与单纯CwG相似,但单次惊厥时间>5 min者较多,近期预后良好,远期神经功能影响需进一步研究。

Objective To investigate the clinical characteristics of reversible splenial lesion syndrome(RESLES)in infants with mild gastroenteritis complicated with benign convulsion(CwG).Methods The infants with CWG admitted to hospital from January 2010 to January 2019 were selected and divided into alone CWG group and CWG complicated with RESLES group(RESLES group)according to head-MRI criteria for RESLES.The general condition,family history,clinical manifestations and prognosis were analyzed retrospectively and compared between two groups.Results Out of 77 infants with CwG,69 cases were in alone CWG group,and 8 cases were in RESLES group.The incidence of single seizure duration for more than 5 min in RESLES group was significantly higher than that in CWG group(62.5%vs 17.4%,χ^2=6.060,P=0.014).At the 6-month follow-up,4 cases were lost in CWG group,and there was no significant difference in recurrence rate of seizures between two groups(12.5%vs 13.8%,P>0.05).Conclusion CWG infants with RESLES have the similar clinical manifestations of infants with CWG alone,single seizure duration is more than 5 min.The further study needs to be performed for the long-term neurological effects,even though there is a good short-term prognosis for them.