Clinical outcome of recurrent afebrile seizures in children with benign convulsions associated with mild gastroenteritis

Boman, Chen; Chen, Min; Hong, Siqi; Liao, Shuang; Ma, Jianjun; Li, Tingsong; Jiang, Li

doi:10.1016/j.seizure.2018.05.020

Cited by 18 publications

(38 citation statements)

References 33 publications

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“…Previous studies have shown a favorable prognosis for BCWG [ 7 , 10 ]. The recurrence rate of BCWG has been reported to range from 7.7–16.8% in earlier studies [ 7 , 11 ]. Here, we report similar favorable long-term outcomes: two out of 44 children who completed long-term follow-ups had recurrent seizures that did not develop into epilepsy.…”

Section: Discussionmentioning

confidence: 99%

“…BCWG seizures are often clustered, with generalized tonic-clonic seizures forming the most common type of seizure cluster, although focal or secondary generalized seizures are also observed [ 7 , 12 , 15 ]. Consistent with previous reports, we found that tonic or generalized tonic-clonic seizures were the most common types of seizures associated with BCWG; however, it is very likely that BCWG originated as a focal event as spikes were observed in the EEG tests that were localized to various regions of the cortex.…”

Section: Discussionmentioning

confidence: 99%

“…Although BCWG has been recognized as benign partial epilepsy in infancy, the International League Against Epilepsy (ILAE) has not officially classified BCWG [ 6 ]. At present, BCWG is generally considered to be a benign situation-related seizure rather than epilepsy [ 7 ]. The disease is often described as an afebrile seizure associated with mild gastroenteritis, and no abnormalities in laboratory test results have been reported.…”

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics, treatment, and long-term outcomes in children suffering from benign convulsions with mild gastroenteritis: a retrospective study

Hao

Liang

et al. 2020

BMC Pediatr

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Background Benign convulsions with mild gastroenteritis (BCWG) is a common condition in children in Asia and is generally not associated with pH or electrolyte imbalances. When BCWG is diagnosed, a lumbar puncture is usually recommended to rule out potential intracranial infections. This study examined the clinical characteristics of BCWG and evaluated the necessity of lumbar puncture. Methods Medical records of children admitted to the First Hospital of Jilin University with BCWG between January 2018 and May 2019 were reviewed and analyzed. Children were stratified by rotavirus positivity or lumbar puncture status. Clinical characteristics and long-term outcomes were compared between groups. Results A total of 51 children were included in the analyses (55.1% rotavirus [HRV] positive). The average age of convulsion onset was 21.12 ± 7.44 months, the male-to-female ratio was 1.8:1, and convulsions occurred primarily between October 2018 and April 2019. The main clinical presentations of BCWG were convulsions, vomiting, diarrhea, and fever. Convulsions occurred predominantly two days after diagnosis of gastroenteritis, were mainly generalized tonic-clonic with 88.2% of children having ≤ 3 convulsions per episode, and had a mean duration of 2.0 minutes (interquartile range [IQR]: 1.0, 3.0). Children with BCWG had mild metabolic acidosis (HCO3− 17.82 ± 3.63 mmol/L) with an elevated anion gap (AG; 20.98 ± 3.00 mmol/L), mild hyponatremia (134.56 ± 2.85 mmol/L), and slightly increased levels of creatine kinase myocardial band (CKMB). HRV + children had more severe acidosis and higher CKMB levels. Cerebrospinal fluid (CSF) samples collected via lumbar puncture were normal. No developmental abnormalities were noted as assessed by the Social Life Ability Scale. Conclusions BCWG is a situation-related seizure, with clinical presentations of tonic-clonic or focal convulsions and mild gastroenteritis (vomiting, diarrhea). Mild metabolic acidosis and hyponatremia may exist. The prognosis of the disease is favorable; lumbar puncture and long-term antiepileptics are unnecessary and should not be recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Clinical characteristics, treatment, and long-term outcomes in children suffering from benign convulsions with mild gastroenteritis: a retrospective study

Hao

Liang

et al. 2020

BMC Pediatr

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“…The prognosis of CwG is good, with the affected children developing normally before and after seizures and having no disability even when experiencing clustered seizures during the acute stage [2,7,30,31]. Progression to epilepsy from CwG has been rarely reported [7,8,22,24].…”

Section: Clinical Characteristicsmentioning

confidence: 99%

“…CwG are benign convulsions that occur between the ages of 6 months and 3 years, with this age range first defined by Komori et al [3] in 1995. However, the age range of patients with CwG has been estimated in the literature as being as broad as from 1 month to 6 years [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][22][23][24][25][26]30,31]. Hypoglycemia, an electrolyte imbal-ance such as hyponatremia or hypocalcemia, and central nervous system infection that can trigger seizures have to be excluded in this definition .…”

Section: Introductionmentioning

confidence: 99%

Benign Convulsions with Mild Gastroenteritis

Kim

2020

Ann Child Neurol

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Benign convulsions with mild gastroenteritis (CwG) are a well-known type of benign seizures that occur in infants and children aged between 6 months and 3 years and are associated with acute (viral) gastroenteritis. The pathogens found in the stool of CwG patients are mostly rotavirus or norovirus, which can result in mild dehydration. Short-lasting seizures (≤5 minutes) occur in clusters within 24 hours, without provoking features such as fever, abnormal laboratory findings in the blood (e.g., hypoglycemia, hyponatremia, or hypocalcemia), or abnormal results in the cerebrospinal fluid (e.g., central nervous system infection). Electroencephalography in CwG patients shows normal or mildly abnormal findings, and brain imaging findings are normal. Affected children develop normally before and after the seizures. The occurrence of seizures does not require the repeated use of first-or second-line intravenous antiepileptic drugs in the acute stage or daily antiepileptic drug medications, since they usually do not recur and have a good prognosis. Patients with CwG rarely have a family history of epilepsy. Although the mean interval between enteric symptom onset and seizure onset in CwG is roughly 2 days, some patients can experience seizures before enteric symptoms, meaning that clinicians should exercise caution during early winter and spring, when the prevalence of CwG is especially high. Additionally, reports of CwG in Korea are roughly as common as in Japan and other East Asian countries, and pediatricians should therefore be familiar with its clinical characteristics and take care not to overprescribe antiepileptic drugs in patients with CwG.

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Prognosis of adults and children following a first unprovoked seizure

Neligan

Adan

Nevitt

et al. 2023

Cochrane Database of Systematic Reviews

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This is a protocol for a Cochrane Review (prognosis). The objectives are as follows: Primary objectivesTo provide an accurate estimate of the proportion of individuals going on to have further unprovoked seizures and the development of epilepsy at any subsequent time point, following a single unprovoked seizure (or cluster of epileptic seizures within a 24-hour period, or a first episode of status epilepticus), of any seizure type (overall prognosis).

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Clinical outcome of recurrent afebrile seizures in children with benign convulsions associated with mild gastroenteritis

Abstract: All the recurrent afebrile seizures initially diagnosed as CwG, irrespective of the kinds and frequency of relapses, showed favorable prognoses. CwG maybe falls within the category of situation-related seizures, rather than epilepsy.

Cited by 18 publications

References 33 publications

Clinical characteristics, treatment, and long-term outcomes in children suffering from benign convulsions with mild gastroenteritis: a retrospective study

Clinical characteristics, treatment, and long-term outcomes in children suffering from benign convulsions with mild gastroenteritis: a retrospective study

Benign Convulsions with Mild Gastroenteritis

Prognosis of adults and children following a first unprovoked seizure

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