Norovirus as cause of benign convulsion associated with gastro-enteritis
Norovirus as cause of benign convulsion associated with gastro-enteritis
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DOI：
10.1111/j.1440-1754.2010.01986.x
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发表时间：
2011-06-01
影响因子：
1.7
通讯作者：
Chan, Hin-biu
中科院分区：
文献类型：
--
作者：
Chan, Chi-man Victor;Chan, Chun-wing Desmond;Chan, Hin-biu
目的：轮状病毒和诺如病毒胃肠炎(GE)在儿童中较为常见。除严重脱水外，并发症很少见。轮状病毒已知会导致癫痫发作，甚至GE脑病，但这些并发症在诺沃克病毒感染中描述较少。本研究旨在比较轮状病毒及诺沃克病毒感染的儿童的人口学特征、临床表现(包括无热性惊厥的发生率)及转归。方法：对2006年6月1日至2009年5月31日期间在香港一间区域医院儿科住院的1个月至6岁轮状病毒及诺沃克病毒感染的儿童进行回顾性分析。结果：共收治轮状病毒感染患儿232例，诺如病毒感染患儿173例。诺如病毒感染常发生无热性惊厥(8.67%vs.1.29%，P<；0.001)。轮状病毒感染的儿童体温更高，腹泻发作更多，而诺如病毒组的粪便中有更多血迹。轮状病毒感染的患者住院时间更长。均痊愈出院，无并发症。在18例出现无热性惊厥的患者中，17例进行了神经成像，这是正常的。其中14人进行了脑电(EEG)检查，显示正常或非特异性发现。结论：与轮状病毒相比，诺沃克病毒更常与良性惊厥有关。我们需要确定病毒的存在，特别是诺沃克病毒，在GE和无热性全面性强直-阵挛发作的儿童中。一旦病因学确定，进一步的神经研究可能就没有必要了。这组儿童预后良好，不需要预防性抗惊厥药物。
Aim: Rotavirus and norovirus gastro-enteritis (GE) are common in children. Complications, except severe dehydration, are rare. Rotavirus was known to cause seizures and even GE encephalopathy, but these complications are less described in norovirus infection. The objective of this study is to compare the demographic features, clinical manifestations including the incidence of afebrile seizure, and the outcomes in children with rotavirus and norovirus infections.Methods: This is a retrospective review of children between age 1 month and 6 years admitted to the paediatric department of a regional hospital in Hong Kong with rotavirus and norovirus infections over a period of 3 years from 1 June 2006 to 31 May 2009. Their demographic data, clinical features, laboratory results and outcomes were compared and analysed.Results: Two hundred and thirty-two children with rotavirus and 173 children with norovirus GE were admitted within the study period. Afebrile seizure commonly occurred in norovirus infection (8.67% vs. 1.29%, P < 0.001). Children with rotavirus infection had higher temperature and more diarrhoea episodes, while more blood-stained stool was noted in the norovirus group. Rotavirus-infected patients stayed longer in hospital. All of them had full recovery without any complication. Among the 18 patients who developed afebrile convulsions, 17 of them had neuroimaging performed, which was normal. Fourteen of them had electroencephalogram (EEG) performed, demonstrating normal or non-specific findings. None of them developed subsequent seizure attack after the GE episode.Conclusions: Norovirus is more commonly associated with benign convulsion in GE than rotavirus. We need to identify the presence of virus, in particular norovirus, in children with GE and afebrile generalised tonic-clonic seizure. Further neuro-investigations may not be necessary once the aetiology is established. Prognosis is excellent in this group of children and prophylactic anticonvulsant is not needed.