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KMID : 0391520160240030095
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Journal of the Korean Child Neurology Society
2016 Volume.24 No. 3 p.95 ~ p.101
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The Comparison of Benign Convulsion with Noroviral and Rotaviral Gastroenteritis
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Choi Mi-Ran
Kwon Young-Se
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Abstract
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Purpose: CwG is a characteristic afebrile seizure associated with acute viral gastroenteritis in children with favorable prognosis, but its pathophysiologic mechanism is not fully identified. The specific pathogens like rotavirus and norovirus are known to be the cause. This study was performed to provide the clinical characteristics of convulsions with gastroenteritis by rotavirus and norovirus in children.
Methods: Retrospective analysis was performed on pediatric patients admitted with acute gastroenteritis to Inha University Hospital from November 2011 to September 2015. We reviewed their demographic data, clinical symptoms and characteristics of seizures, laboratory and electroencephalogram(EEG) findings.
Results: Among the 1,645 patients with acute gastroenteritis, 1,350 patients had stool antigen tests for the detection of rotavirus and norovirus. Of these, norovirus and rotavirus isolates were detected in 162 patients and 183 patients, respectively. Among them, the 18 patients (11.1%) were diagnosed as convulsion with mild gastroenteritis (CwG) with norovirus infection and the 9 patients (4.9%) as CwG with rotavirus infection. We found that rotavirus-associated CwG had a higher mean age (33.3 months vs. 17.3 months, P=0.005) and a higher recurrence rate of seizures (55.6% vs. 38.9%, P=0.411) than did norovirus-associated CwG. We found the number of CwG caused by rotavirus peaked from winter to early spring, but that of norovirus peaked from fall to winter. In both groups, females were more than males (M:F=3:6 vs. 8:10, in rotavirus and norovirus respectively, P=0.580). There were no significant abnormalities in laboratory and neuroimaging findings except one case with few spike discharges on EEG. None of them had any neurological sequelae at the follow-up.
Conclusion: As the mean age of noroviral CwG was younger than that of rotaviral CwG, we need to perform the detection tests of norovirus infection for CwG patients with younger age, especially younger than 2 years, and the pediatric neurologists should pay more attention to norovirus.
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KEYWORD
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Seizures, Gastroenteritis, Rotavirus, Norovirus
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