Clinical characteristics of convulsions associated with mild gastroenteritis in children
Keywords:
convulsion associated with mild gastroenteritis, clinical characteristic, treatmentAbstract
Background: Convulsions associated with mild gastroenteritis (CwG) is a clinical condition characterized by afebrile convulsions occurring in healthy children with the presence of mild acute gastroenteritis. This condition is common in Asia; however, limited information is available in Thailand.
Objective: To determine clinical characteristics, treatment and outcome in children with CwG.
Method: The observational descriptive study was conducted in Ratchaburi Hospital. Medical records of children age 1 month to 6 years diagnosed with CwG between May 1, 2016 to April 30, 2021 were reviewed.
Results: 25 children (48% males) were included. The mean age was 24.4 ± 16.93 months. Generalized onset seizure (92%) was the most common seizure type with median number of seizures was 2 (range 1-3). The associated gastrointestinal symptoms were diarrhea (88%) followed by vomiting (60%). Comparing 17 (68%) children who had seizure > 1 and 8 (32%) children who had one seizure, generalized onset seizure occurred in all children having > 1 seizure and in 6 children with single seizure (100% vs 75%, p = 0.032). Antiseizure medications (ASMs) were administered in 14 (56%) children during acute phase. While diazepam followed by phenytoin were given in 8 (47%) children having > 1 seizures, only 3 (38%) children with single seizure received ASMs. Electroencephalography (EEG) was performed in 20 children, which 18 (90%) EEGs were normal and 2 (10%) showed interictal
spikes. Of 25 children, all but one did not receive continuous ASMs. The mean duration of follow-up was 5.68 ± 5.33 months. None have recurrence of seizure.
Conclusion: Majority of children with CwG experienced multiple seizures, however, no seizure recurrence was noted in this study. These findings highlight the clinical course of CwG that pediatrician should recognize it and minimize unnecessary extensive evaluation and treatment. Clinical follow-up is recommended.
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