Comparative Study On The Clinical Features Between The Cases Of Convulsion With Rotavirus Gastroenteritis And Pure Rotavirus Gastroenteritis

Objective:To investigate the differences of the clinical manifestations and prognosis between convulsion in infants with rotavirus gastroenteritis and rotavirus gastroenteritis(RVGE).Methods:315 patients were treated between January 2010 and December 2013. Subjects were divided into 212(67.3%) cases of the seizure group S and 103(32.7%) cases of no seizure group NS. The differences between the two groups in demographic, clinical characteristics,laboratory test results, EEG, brain CT, brain MRI, antiepileptic treatment, and follow-up prognosis were compared.Results:In the S group, the average duration of gastrointestinal symptoms were 2.45 days before the onset of seizures; 209 patients(98.59%) had generalized seizure,3(1.41%) had focal seizures; Seizures had occurred ranging from 1 to 10 episodes twice in 24.06% of cases); the duration of seizures ranging from 5s to 30min(<5 min in 80.19%and >15min in11% of cases). There were significant differences in family history(10.38% vs 1.08%,P=0.003) and previous history of seizures(10.38% vs 1.08%, P=0.003)of S group compared with NS group; There were statistically significant differences in S group and NS group on the white blood cell count(7685 ±2848 vs 8841 ±3338 /mm3, P=0.002), the concentration of serum sodium(135.22 ±3.74 vs 137.01 ± 2.55mmol/L, P=0.000), the concentration of serum calcium(1.24 ±0.07 vs 1.29 ± 0.10mmol/L, P=0.000), serum lactate concentration(2.04 ± 1.09 vs 2.30 ± 0.88mmol/L, P=0.037), serum standard bicarbonate concentration(19.84 ± 2.11 vs 17.85 ± 1.96mmol/L, P=0.000), serum actual bicarbonate concentration(16.96 ± 2.50 vs 14.90 ± 2.36mmol/L, P=0.000), serum plasma carbon dioxide content(17.79 ± 2.66 vs 15.77 ± 2.31mmol/L, P=0.000) and the p H(7.41 ±0.05 vs 7.37 ± 0.05/L P=0.000). Interictal electroencephalography was performed in 103 patients in group S, 9 patients showed nonspecific abnormalities, but the follow-up EEGswere normal. During the follow-up period(telephone, outpatient follow-up)which ranged from 1 to 4years, 3(7.07%)patients of group S had febrile seizure after discharge,4(2.17%)patients had afebrile seizure, only 1(0.54%)patients was diagnosed epilepsy after half a year, treating with topiramate. In group NS, 2(2.15%) patients had febrile seizure.The recurrence of seizure in two groups of the patients was significant difference(9.24% vs2.22%, P=0.028). The two groups had no significant difference in the probability of epilepsy. None of them had abnormal development in athletics and cognitive impairment.Conclusion1.There is no significant difference in the average hospitalization days, the sequelae of nervous system and prognosis between convulsion with rotavirus gastroenteritis and rotavirus gastroenteritis.2.Whether convulsion is associated or not is not the determining factor of the prognosis of gastrointestinal rotavirus.3.This study also showed that seizures and no seizures associated with RVGE are mostly benign in clinical course and prognosis, some unnecessary investigations for this clinical entiry are not needed.