Risk factors for the recurrence of convulsions with mild gastroenteritis in children

Abstract

To identify risk factors for the recurrence of convulsions with mild gastroenteritis (CwG) 1 in children. Methods: Altogether, 613 children with CwG admitted to Children's Hospital of Shanxi Province from January 2010 to December 2015 were selected, their clinical data were retrospectively analyzed, and patients were followed up for 4-10 years. Risk factors for the recurrence of CwG were analyzed based on the clinical characteristics of the children. Results: Relapse occurred in 35 patients (6.3 %). Recurrence occurred within 6 months after the first CwG in majority of the patients (80 %), and recurrence occurred once in most patients (91.4 %). Risk factors associated with CwG recurrence were age at first attack of ≤18 months (recurrence rates at ages ≤ and > 18 months were 8.7 %, and 3.1 %, respectively; χ2 = 4.856, P = 0.028), and a history of convulsions in first-degree relatives (recurrence rates in first-degree relatives with and without a history of convulsion were 20 % and 6.2 %, respectively; χ2 = 5.501, P = 0.019). Conclusions: Children with CwG have a possibility of recurrence. The risk of recurrence within 6 months of onset is high and such patients should be carefully observed. Furthermore, the age of onset of ≤18 months and history of convulsions in first-degree relatives are risks factors for CwG recurrence; therefore, these children should be closely followed up. Material and methods ParticipantsThe clinical data of 613 children with CwG diagnosed at Children's Hospital of Shanxi from January 2010 to December 2015 were retrospectively analyzed. The inclusion criteria were as follows [9-12]: (1)

Risk factors for recurrence of benign convulsions with mild gastroenteritis in children: A prospective cohort study

“…3 Previous studies conducted on the recurrence of CwG in children have reported a recurrence rate varying between 4.7 and 16.8%. 5,6,7,8 We found a recurrence rate of 4.9% in our study, indicating that the risk of CwG recurrence is still high. Hence, physicians should inform the parents at the onset about the recurrence risk of CwG to avoid panic.…”

“…Similar findings were reported by Chen et al ., Shi et al . and Wang et al 3,6,7 . Hence, these studies had concluded that physicians should avoid extensive evaluations and long‐term anti‐epileptic treatment in children with CwG 3 .…”

“…Majority of brain development occurs by five years. This increased brain susceptibility to seizures at an early age is possibly due to an immature nervous system with incompletely formed neuronal dendrites and myelin sheath 6,7 . Thus, children who have their CwG at an early age have more time left during the developmental window of susceptibility to have another seizure.…”

“…The inclusion criteria were identical to those described in previous studies: (i) children aged 6 months to 3 years of age; (ii) mild gastroenteritis with afebrile convulsions, no or mild dehydration, normal metabolic and electrolyte panel; and (iii) normal neuroimaging, electroencephalogram (EEG). 3,4,5,6 We excluded cases with developmental disorders, epilepsy, encephalitis, meningitis, drug-induced or due to encephalopathy. Patients who were re-admitted for CwG more than once during the study period were considered as one case.…”

Febrile and afebrile seizures associated with mild acute gastroenteritis in childhood

“…Although many studies in the past showed good prognosis of CwG, in recent years, with the increase in follow-up studies being conducted, it was found that children with CwG have some risk of seizure recurrence. Furthermore, if the age of seizure onset is ≤ 18 months and if there is a positive family history of epilepsy or febrile seizures, these children should be closely followed up within 6 -12 months from the first episode [17].…”