| Objectives1. To investigate whether nitric oxide (NO) is involved in the pathogenesis of infantile convulsions with mild gastroenteritis (ICG)2. To study whether central vascular endothelial and neuronal damage is the mechanisms of ICG convulsions.3. To study the common pathogens in ICG and the difference between number of episodes of different pathogens-related convulsions.Methods1. The study group was composed of 30 cases of infants with convulsions and mild gastroenteritis (ICG group), which were further divided into two groups according to seizure frequency:seizure frequent group(18 cases) (≥3 times) and non-frequent group(12 cases) (<3 times). Another 25 patients with mild viral encephalitis (VE) group and 14 patients with congenital malformations (spina bifida or meningocele, etc.) but with normal psychomotor development and without convulsion history were used as negative control group, respectively.2. NO in cerebrospinal fluid (CSF) is measured by nitrate reductase method and vascular endothelial growth factor (VEGF), vascular endothelial growth factor (VCAM-1), nitric oxide synthase(NOS), and neuron-specific enolase(NSE) were measured by enzyme-linked immunosorbent assay (ELISA) method.3. Real-time polymerace chain reaction(real-time PCR) was used to test rotavirus (RV) and norwalk virus (NoV) in the stool of all 30 cases with ICG. if positive results were obtained, corresponding virus detection will be performed in cerebrospinal fluid using the same method.4. To study the difference between number of episodes of different pathogens-related convulsions. 5. Statistical differences were analyzed by SPSS13.0. All values were expressed as mean±SD. Student t or t'test was used to compare the mean difference between two groups. P<0.05 was regarded as statistically significant.Results1. The levels of VEGF and VCAM-1 in ICG group were significantly lower than the VE group (P<0.05), however, no significant difference was reached compared with negative control group (P>0.05). Furthermore, NO and NOS levels in ICG group were significantly higher than in VE group and negative control group (P< 0.01). Moreover, NSE level in ICG group was significantly lower than in VE group (p <0.01), but significantly higher than in negative control group (P<0.05).2. Levels of NO and NOS were significantly higher in non-frequent group than in the VE group (P<0.05). Levels of VEGF, VCAM-1 and NSE were significantly decreased in negative control group compared to seizure frequent group (P<0.05), but there is no statistical difference in comparison with non-frequent group (P>0.05). Additionally, the diffrence of levels of NO and NOS in non-frequent group and frequent group has statistical significance (P<0.05)3. Rotavirus and Norwalk virus detection results in cerebrospinal fluid and the stool:The numbers of RV-positive in stool are 17/30 people (57%), and 3/17 (18%) in cerebrospinal fluid. The numbers of NoV-positive in stool are 6/30 (25%), and 1/6 (17%) in cerebrospinal fluid. The seizures of 4 cases whose CSF virus is positive were frequent and their levels of VEGF,VCAM-1,NSE in CSF have no statistical difference in comparison with CSF virus negtive cases in frequent group.4. Difference between number of episodes of different pathogens infection-related convulsions:The average seizure frequency is 4.33±1.75 times for children with NoV infection,2.53±1.12 times with RV infection. Seizure frequency was significantly higher in NoV infection group than in RV infection group (P<0.01).Conclusion1. Nitric oxide (NO) level rising maybe one of the mechanisms of ICG convulsions.2. Although virus is found in a few cases' cerebrospinal fluid, there is no evidence that the central vascular endothelial and neuronal damage, mild viral encephalitis is the mechanism of ICG convulsion.3.RV and NoV are the main pathogens leading to ICG and NoV infection leads to occurrence of seizures more frequent than RV.4. Frequent seizures of patients with ICG can lead to central vascular endothelial and neuronal damage, positive control seizures in acute stage of ICG in order to avoid central injury, resulting in morbidity...
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