| Objective:BICE refers to the syndrome in which the infants from 6 months to 3 years old are previously healthy, have mild gastroenteritis associated with convulsions and may have mild-to-moderate dehydration; it belongs to benign convulsions except conic seizures caused by intracranial infection, intracranial organic disease, fever, acidosis and electrolyte imbalance. The prognosis is good, in general, it does not affect the infants’ development. In this thesis,96 cases of infants with BICE are analyzed. In order to get more treatment experience and understanding, the thesis reviews the previous literature and summarizes the EEG of the seizure syndrome, etiology and the clinical characteristics of the diseaseMethods:The thesis select 96 infants hospitalized with syndrome of mild gastroenteritis and benign convulsions (51 females,45 males. Minimum age 2 months and 11 days, the maximum age 2 years and 8 months. The average age 1 year and 4 months) to further analyze their epidemiology, personal history, family history, clinical manifestations, etiology, EEG, imaging and the laboratory tests, etc. In the process of retrospective analysis, the thesis aims to analyze its etiology, EEG and other features.Application of SAS for data analysis:measurement data with the mean ±tandard deviation, maximum value, minimum value; count data expressed as percentage of the number of cases, count data were compared with the chi square test, Fisher exact test, P<0.05 has statistical significance difference.Result:In the 96 cases, there are 27 cases diagnosed with mild gastroenteritis and benign convulsions syndrome, and 69 cases undiagnosed when the infants discharged with great possibilities. (1) In general:45 male cases,51 female cases, male:female= 1:1.3. The minimum age is 2 months and 11 days; the maximum age is 2 years and 8 months; the average age is 1 year and 4 months. The incidence of 6 months is 4 cases (4.2%); the incidence of 6 months to 1 year is 11 cases (11.5%); the incidence of 1 year to 2 years is 75 cases (78.1%), and the incidence of 2 to 3 ears is 6 cases (6.2%). (2) Personal and family history:6 cases have abnormal personal history and 10 cases have abnormal family history. (3) Clinical features:the onset is diarrhea or vomiting.12 cases have fever (12.5%); 15 cases have mild-moderate dehydration (15.6%); 85 cases have seizures within 1-5 days after the gastroenteritis (88.6%); 58 cases have episode 1-2 convulsion (group Al) in (60.4%),22 cases have episode 3 times (group A2) (22.9%),16 cases have attack more than 3 times (group A3) (16.7%). Compared with each other, Among them was statistically significant A1 and group A2、A1 and A3 group (groupA1 vs group A2:x2 =27.771, P=0.000,<0.05; groupA1 vs group A3:χ2=38.787, P=0.000, <0.05), had no significant difference in A2 and A3 group(x2= 1.181, P=0.227,>0.05); 84 cases of generalized seizures(87.5%),12 cases of focal seizures(12.5%), there is significant difference between them(x2=108, P=0.000<0.05). (4) Laboratory tests:24 cases have high blood (25%); 2 cases have mild anemia (2%); 3 cases have mildly abnormal liver function; 2 cases have abnormal cardiac markers; 16 cases have mild electrolyte abnormalities (16.7%); 53 infants don not have blood analysis; and one case has hypoglycemia (1%). (5) Stool and stool culture: stool rotavirus are tested negative in 30 cases (31.3%); rotavirus are tested positive in 59 cases (61.5%); 1 case has visible mold (1%); 1 case has Proteus (1%); 1 extramural case has Proteus mirabilis. There is significant differences in detection of rotavirus positive group (59 cases) and the detection of rotavirus negative group (30 cases).(6) Cerebrospinal fluid test: there are no obvious abnormalities.(7) EEG:The normal EEG and video EEG are normal in 62 cases (64.5%, group B1); there are 16 cases of the boundaries of the EEG(group B2),10 cases suggesting that suspicious epileptiform discharges (10.4%).6 cases prompt that the background is slowing down (6.3%),12 cases have EEG abnormalities (12.5%, group B3), all prompting the background is slowing down. Compared with each other, and the difference is significant (groupBl vs group B2:%2=47.873, P=0.000,<0.05; group B1 vs group B3:χ2=57.369, P=0.000,<0.05), There were no significant differences in B2 and B3 group(x2=0.677, P=0.411,>0.05)(8) CT or MRI test:there are 70 cases of the CT or MRI tested. No obvious abnormalities account for 68 cases (97%); abnormal MRI signal source in the left frontal skull plate accounts for 1 case (1%); abnormal white matter signal accounts for 1 case (1%); 54 cases have normal CT or MRI,16 cases have abnormal CT or MRI, the difference is significant (χ2=41.257, P=0.000,<0.05).72 cases of generalized seizures have normal CT or MRI, abnormal accounted for 12 cases,8 cases of focal seizures have normal CT or MRI, abnormal accounted for 4 cases, There is no statistically significant differences in 2 seizure types and imaging of normal or no (P=0.111,>0.05).(9) Treatment and follow-up:Through panic stop (if necessary), maintaining a stable internal environment, such as rehydration, diarrhea, antiemetic, antivirus, gastrointestinal mucosa’s protection and intestinal flora regulation treatment, all patients are cured and have recovered well. Besides, when they review, the EEG is normal. EEG normal children did not come to the hospital review EEG. only 32 cases of children with seizures can be followed up to so far no further seizures, abnormal EEG for children 26 cases can be followed up to 20 patients over a period of 1 year follow-up, all patients reviewed EEG was normal, no use of anti-epileptic drugs, intellectual movement without exception, without neurological sequelas occur, including 2 patients discharged after 4 months,12 months later again exhibit the same symptoms, but will soon be effectively controlled seizures.Conclusion:(1) BICE seizures occur in the early period of acute gastroenteritis. Generally speaking, its episodes are not more than 3 times, mainly in the form of generalized tonic seizure or generalized tonic seizure.(2) Etiology is mainly based on rotavirus infection, accompanied by rotavirus enteritis.(3) In the interictal phase, there are no obvious abnormalities in EEG, with a few suspicious epileptic discharge and background slowing. But it can return to the normal after review In 1 years.(4) BICE is easy to control and not necessary to get antiepileptic treatment. Meanwhile, it does not affect the infants’growth and development after the prognosis.(5)The vast majority of children with BICE brain imaging (CT/MRI) examination is normal, it is also one of the reasons BICE who have a good prognosis. |
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