Clinical Characteristics Of Benign Infantile Convulsions With Mild Gastroenteritis

Background:Benign infantile convulsions with mild gastroenteritis(BICE) was first reported by Japanese scholar in 1982, after that, in recent twenty years BICE got more and more attention all over the world gradually. The disease often occurs in healthy infants, characterized by mild vomiting and diarrhea with afebrile convulsion, lab and EEG examination are normal, and the prognosis is good. But there are also many clinicians still do not know BICE very well. They may be misdiagnose the disease as ion or acid-base balance disorders, hypoglycemia, viral encephalitis, encephalopathy etc that can cause convulsions, Or make a diagnosis of epilepsy and give antiepileptic therapy for a long time. I hope that through this article to increase awareness of the electroclinical features of BICE, and help to diagnose correctly and reduce unnecessary diagnosis and treatment. Purpose:By Exploring the clinical characteristics and prognosis BICE, we can improve the understanding of the disease. Method:We collected and analyzed the medical data of 55 patients diagnosed with BICE who were assessed in the No.1 Hospital of Jilin University pediatric neurology Department between November 2013 and October 2015. The medical data include: General information, clinical manifestation, auxiliary examination, treatment and prognosis. And we visited the children follow-up after discharge by phone or outpatient. At the same time, we divided all children into two groups: rotavirus positive and negative group, and made Comparison and analysis of clinical characteristics and laboratory test results between the two groups. Results:There are 26 males and 29 females; the age of onset was 6-31 months, average 18.36 ±5.34 months; the incidence of the disease mainly concentrated in November to March of the following year; the treatment time was 1-3 days after the onset. All the children had diarrhea, most were less than 5 times / day, the duration of diarrhea was 3-7 days. 85.45% children had vomiting. 54 cases’ gastroenteritis symptoms attacked before seizure, only 1 case’s gastroenteritis symptoms attacked 1 days after convulsion. The seizures were most general, the frequency of seizures was within 3 times, the duration of the seizure was mainly within 5 min, and the nervous system physical examination of was normal. The average value of blood sodium was 136.4±3.74mmol/L, which was lower than the normal value, and the CKMB was slightly increased, which was 51.11±25.28mmol/L. The rotavirus antigen test was performed in all patients, which negative in 22 cases, positive in 33 cases and the CKMB of positive group was 63.00±23.75 mmol/L the comparison between two groups has statistical difference. 8 cases EEG had small spikes in the frontal area, temporal area or the central parietal area, but after 3 months, all turned into normal,; The CT or MRI were normal. The average hospital stay was 6.91±1.52 days, and the follow-up was 4-23 months, and 1patient had seizures again 13 months after discharge. All children’s growth and development were normal between follow-up.Conclusions:(1) The peak age of onset of BICE is 12-24 months, and the frequently-occurring time is autumn and winter, most in November to March in the following year(2) Mild gastroenteritis symptoms often precede convulsions, most seizures are general and most duration is less tan 5 minutes(3) BICE patients always have high rate of rotavirus and these patient are easy to having Creatine kinase isoenzyme MB moderately to decrease.(4) The prognosis of BICE is excellent without long-term antiepileptic therapy.