Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Benign convulsion with mild gastroenteritis

  • Kang, Ben (Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Kwon, Young Se (Department of Pediatrics, Inha University Hospital)
  • 투고 : 2014.02.19
  • 심사 : 2014.06.03
  • 발행 : 2014.07.10
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초록

Benign convulsion with mild gastroenteritis (CwG) is a type of afebrile seizure that occurs in children. CwG is defined as a convulsion in a previously healthy child with no known central nervous system infection or encephalopathy, accompanying mild diarrhea without fever, electrolyte imbalance, or moderate to severe dehydration. Convulsions in CwG are characterized by multiple brief episodes of generalized or focal seizures. Although the etiology and pathophysiology have yet to be fully explained, many pathogenic mechanisms have been proposed including the possibility of direct invasion of the central nervous system by a gastrointestinal virus such as rotavirus or the possibility of indirect influence by the production and effects of certain mediators. The electroencephalogram findings are benign and long-term antiepileptic treatment is typically not required. Long-term prognosis has been favorable with normal psychomotor development. This review provides a general overview of CwG with the goal of allowing physicians practicing in the field of pediatrics to better recognize this unique entity and, ultimately, to minimize unnecessary evaluation and treatment.

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참고문헌

  1. Morooka K. Convulsions and mild diarrhea. Shonika (Tokyo) 1982;23:131-7.
  2. Komori H, Wada M, Eto M, Oki H, Aida K, Fujimoto T. Benign convulsions with mild gastroenteritis: a report of 10 recent cases detailing clinical varieties. Brain Dev 1995;17:334-7.
  3. Berg AT, Berkovic SF, Brodie MJ, Buchhalter J, Cross JH, van Emde Boas W, et al. Revised terminology and concepts for organization of seizures and epilepsies: report of the ILAE Commission on Classification and Terminology, 2005-2009. Epilepsia 2010;51: 676-85.
  4. Uemura N, Okumura A, Negoro T, Watanabe K. Clinical features of benign convulsions with mild gastroenteritis. Brain Dev 2002;24:745-9.
  5. Hung JJ, Wen HY, Yen MH, Chen HW, Yan DC, Lin KL, et al. Rotavirus gastroenteritis associated with afebrile convulsion in children: clinical analysis of 40 cases. Chang Gung Med J 2003;26:654-9.
  6. Cho JH, Joo KE, Kim SK, Shin SH, Lee KH, Yoon HS. Clinical study of benign convulsion with acute gastroenteritis. Korean J Pediatr 2004;47:855-60.
  7. Lee JS, Kwon HO, Jee YM, Chae KY. Clinical features of benign infantile convulsions with gastroenteritis. Korean J Pediatr 2005;48:753-9.
  8. Kawano G, Oshige K, Syutou S, Koteda Y, Yokoyama T, Kim BG, et al. Benign infantile convulsions associated with mild gastroenteritis: a retrospective study of 39 cases including virological tests and efficacy of anticonvulsants. Brain Dev 2007;29:617-22.
  9. Motoyama M, Ichiyama T, Matsushige T, Kajimoto M, Shiraishi M, Furukawa S. Clinical characteristics of benign convulsions with rotavirus gastroenteritis. J Child Neurol 2009;24:557-61.
  10. Chen SY, Tsai CN, Lai MW, Chen CY, Lin KL, Lin TY, et al. Norovirus infection as a cause of diarrhea-associated benign infantile seizures. Clin Infect Dis 2009;48:849-55.
  11. Lee EH, Chung S. A comparative study of febrile and afebrile seizures associated with mild gastroenteritis. Brain Dev 2013;35:636-40.
  12. Kang B, Kim DH, Hong YJ, Son BK, Kim DW, Kwon YS. Comparison between febrile and afebrile seizures associated with mild rotavirus gastroenteritis. Seizure 2013;22:560-4.
  13. Narchi H. Benign afebrile cluster convulsions with gastroenteritis: an observational study. BMC Pediatr 2004;4:2.
  14. Caraballo RH, Ganez L, Santos Cde L, Espeche A, Cersosimo R, Fejerman N. Benign infantile seizures with mild gastroenteritis: study of 22 patients. Seizure 2009;18:686-9.
  15. Cusmai R, Jocic-Jakubi B, Cantonetti L, Japaridze N, Vigevano F. Convulsions associated with gastroenteritis in the spectrum of benign focal epilepsies in infancy: 30 cases including four cases with ictal EEG recording. Epileptic Disord 2010;12:255-61.
  16. Dura-Trave T, Yoldi-Petri ME, Gallinas-Victoriano F, Molins-Castiella T. Infantile convulsions with mild gastroenteritis: a retrospective study of 25 patients. Eur J Neurol 2011;18:273-8.
  17. Lloyd MB, Lloyd JC, Gesteland PH, Bale JF Jr. Rotavirus gastroenteritis and seizures in young children. Pediatr Neurol 2010;42:404-8.
  18. Verrotti A, Nanni G, Agostinelli S, Parisi P, Capovilla G, Beccaria F, et al. Benign convulsions associated with mild gastroenteritis: a multicenter clinical study. Epilepsy Res 2011;93:107-14.
  19. Verrotti A, Tocco AM, Coppola GG, Altobelli E, Chiarelli F. Afebrile benign convulsions with mild gastroenteritis: a new entity? Acta Neurol Scand 2009;120:73-9.
  20. Goldwater PN, Rowland K, Thesinger M, Abbott K, Grieve A, Palombo EA, et al. Rotavirus encephalopathy: pathogenesis reviewed. J Paediatr Child Health 2001;37:206-9.
  21. Keidan I, Shif I, Keren G, Passwell JH. Rotavirus encephalopathy: evidence of central nervous system involvement during rotavirus infection. Pediatr Infect Dis J 1992;11:773-5.
  22. Blutt SE, Kirkwood CD, Parreno V, Warfield KL, Ciarlet M, Estes MK, et al. Rotavirus antigenaemia and viraemia: a common event? Lancet 2003;362:1445-9.
  23. Fischer TK, Ashley D, Kerin T, Reynolds-Hedmann E, Gentsch J, Widdowson MA, et al. Rotavirus antigenemia in patients with acute gastroenteritis. J Infect Dis 2005;192:913-9.
  24. Sugata K, Taniguchi K, Yui A, Miyake F, Suga S, Asano Y, et al. Analysis of rotavirus antigenemia and extraintestinal manifestations in children with rotavirus gastroenteritis. Pediatrics 2008; 122:392-7.
  25. Nishimura S, Ushijima H, Nishimura S, Shiraishi H, Kanazawa C, Abe T, et al. Detection of rotavirus in cerebrospinal fluid and blood of patients with convulsions and gastroenteritis by means of the reverse transcription polymerase chain reaction. Brain Dev 1993;15:457-9.
  26. Liu B, Fujita Y, Arakawa C, Kohira R, Fuchigami T, Mugishima H, et al. Detection of rotavirus RNA and antigens in serum and cerebrospinal fluid samples from diarrheic children with seizures. Jpn J Infect Dis 2009;62:279-83.
  27. Weclewicz K, Kristensson K, Greenberg HB, Svensson L. The endoplasmic reticulum-associated VP7 of rotavirus is targeted to axons and dendrites in polarized neurons. J Neurocytol 1993; 22:616-26.
  28. Diaz Y, Chemello ME, Pena F, Aristimuno OC, Zambrano JL, Rojas H, et al. Expression of nonstructural rotavirus protein NSP4 mimics Ca2+ homeostasis changes induced by rotavirus infection in cultured cells. J Virol 2008;82:11331-43.
  29. Tian P, Ball JM, Zeng CQ, Estes MK. The rotavirus nonstructural glycoprotein NSP4 possesses membrane destabilization activity. J Virol 1996;70:6973-81.
  30. Ruiz MC, Cohen J, Michelangeli F. Role of Ca2+in the replication and pathogenesis of rotavirus and other viral infections. Cell Calcium 2000;28:137-49.
  31. Yeom JS, Kim YS, Park JS, Seo JH, Park ES, Lim JY, et al. Role of Ca2+ homeostasis disruption in rotavirus-associated seizures. J Child Neurol 2014;29:331-5.
  32. Azim T, Ahmad SM, Sefat-E-Khuda, Sarker MS, Unicomb LE, De S, et al. Immune response of children who develop persistent diarrhea following rotavirus infection. Clin Diagn Lab Immunol 1999;6:690-5.
  33. Casola A, Garofalo RP, Crawford SE, Estes MK, Mercurio F, Crowe SE, et al. Interleukin-8 gene regulation in intestinal epithelial cells infected with rotavirus: role of viral-induced IkappaB kinase activation. Virology 2002;298:8-19.
  34. Jiang B, Snipes-Magaldi L, Dennehy P, Keyserling H, Holman RC, Bresee J, et al. Cytokines as mediators for or effectors against rotavirus disease in children. Clin Diagn Lab Immunol 2003;10:995-1001.
  35. Kawashima H, Inage Y, Ogihara M, Kashiwagi Y, Takekuma K, Hoshika A, et al. Serum and cerebrospinal fluid nitrite/nitrate levels in patients with rotavirus gastroenteritis induced convulsion. Life Sci 2004;74:1397-405.
  36. Choi JH, Kim YJ, Oh JW, Kim CL, Yum MK, Sul IJ, et al. Genotype of rotavirus isolated from patients with rotaviral enteritis and neurological complications. Korean J Pediatr 2006;49:513-8.
  37. Yang HR, Jee YM, Ko JS, Seo JK. Detection and genotyping of viruses detected in children with benign afebrile seizures associated with acute gastroenteritis. Korean J Pediatr Gastroenterol Nutr 2009;12:183-93.
  38. Abe T, Kobayashi M, Araki K, Kodama H, Fujita Y, Shinozaki T, et al. Infantile convulsions with mild gastroenteritis. Brain Dev 2000;22:301-6.
  39. Sakai Y, Kira R, Torisu H, Yasumoto S, Saito M, Kusuhara K, et al. Benign convulsion with mild gastroenteritis and benign familial infantile seizure. Epilepsy Res 2006;68:269-71.
  40. Okumura A, Watanabe K, Negoro T. Benign partial epilepsy in infancy long-term outcome and marginal syndromes. Epilepsy Res 2006;70 Suppl 1:S168-73.
  41. Specchio N, Vigevano F. The spectrum of benign infantile seizures. Epilepsy Res 2006;70 Suppl 1:S156-67.
  42. Guipponi M, Rivier F, Vigevano F, Beck C, Crespel A, Echenne B, et al. Linkage mapping of benign familial infantile convulsions (BFIC) to chromosome 19q. Hum Mol Genet 1997;6:473-7.
  43. Caraballo R, Pavek S, Lemainque A, Gastaldi M, Echenne B, Motte J, et al. Linkage of benign familial infantile convulsions to chromosome 16p12-q12 suggests allelism to the infantile convulsions and choreoathetosis syndrome. Am J Hum Genet 2001; 68:788-94.
  44. Malacarne M, Gennaro E, Madia F, Pozzi S, Vacca D, Barone B, et al. Benign familial infantile convulsions: mapping of a novel locus on chromosome 2q24 and evidence for genetic heterogeneity. Am J Hum Genet 2001;68:1521-6.
  45. Matsufuji H, Ichiyama T, Isumi H, Furukawa S. Low-dose carbamazepine therapy for benign infantile convulsions. Brain Dev 2005;27:554-7.
  46. Berkovic SF, Harkin L, McMahon JM, Pelekanos JT, Zuberi SM, Wirrell EC, et al. De-novo mutations of the sodium channel gene SCN1A in alleged vaccine encephalopathy: a retrospective study. Lancet Neurol 2006;5:488-92.
  47. Weng WC, Hirose S, Lee WT. Benign convulsions with mild gastroenteritis: is it associated with sodium channel gene SCN1A mutation? J Child Neurol 2010;25:1521-4.
  48. Ben-Ami T, Sinai L, Granot E. Afebrile seizures and rotavirus gastroenteritis: an infrequently recognized association. Clin Pediatr (Phila) 2007;46:178-80.
  49. Hongou K, Konishi T, Yagi S, Araki K, Miyawaki T. Rotavirus encephalitis mimicking afebrile benign convulsions in infants. Pediatr Neurol 1998;18:354-7.
  50. Okumura A, Uemura N, Negoro T, Watanabe K. Efficacy of antiepileptic drugs in patients with benign convulsions with mild gastroenteritis. Brain Dev 2004;26:164-7.
  51. Payne DC, Baggs J, Zerr DM, Klein NP, Yih K, Glanz J, et al. Protective association between rotavirus vaccination and childhood seizures in the year following vaccination in US children. Clin Infect Dis 2014;58:173-7.

피인용 문헌

  1. Afebrile Benign Convulsion Associated With Mild Gastroenteritis : A Cohort Study in a Tertiary Children Hospital vol.5, pp.None, 2014, https://doi.org/10.1177/2329048x18773498
  2. Detection and diagnostic value of serum NSE and S100B protein levels in patients with seizures associated with mild gastroenteritis : A retrospective observational study vol.99, pp.48, 2020, https://doi.org/10.1097/md.0000000000023439
  3. Clinical Implications of Ketosis in Children with Benign Convulsions with Mild Gastroenteritis vol.16, pp.1, 2014, https://doi.org/10.3988/jcn.2020.16.1.96
  4. Benign Convulsions with Mild Gastroenteritis vol.28, pp.1, 2014, https://doi.org/10.26815/acn.2019.00248
  5. Older Patients May Have More Frequent Seizures among Children Diagnosed as Benign Convulsions with Mild Gastroenteritis vol.51, pp.5, 2014, https://doi.org/10.1055/s-0040-1701442
  6. Serum Uric Acid as a Predictive Factor for Rotaviral or Noroviral Benign Convulsions with Mild Gastroenteritis vol.28, pp.4, 2014, https://doi.org/10.26815/acn.2020.00143
  7. Epidemiology of Rotavirus Gastroenteritis and Rotavirus-Associated Benign Convulsions with Mild Gastroenteritis after the Introduction of Rotavirus Vaccines in South Korea: Nationwide Data from the He vol.17, pp.22, 2014, https://doi.org/10.3390/ijerph17228374
  8. Clinical characteristics, treatment, and long-term outcomes in children suffering from benign convulsions with mild gastroenteritis: a retrospective study vol.20, pp.1, 2020, https://doi.org/10.1186/s12887-020-02406-0
  9. Benign Convulsions with Mild Rotavirus and Norovirus Gastroenteritis: Nationwide Data from the Health Insurance Review and Assessment Service in South Korea vol.8, pp.4, 2014, https://doi.org/10.3390/children8040263
  10. Understanding the Central Nervous System Symptoms of Rotavirus: A Qualitative Review vol.13, pp.4, 2014, https://doi.org/10.3390/v13040658
  11. Comparison of the Demographics and Ratio of Rotavirus-Associated Benign Convulsions with Mild Gastroenteritis to Rotavirus Gastroenteritis before and after Rotavirus Vaccination over a Period of 20 Ye vol.29, pp.2, 2021, https://doi.org/10.26815/acn.2020.00297
  12. Convulsions in children hospitalized for acute gastroenteritis vol.11, pp.1, 2014, https://doi.org/10.1038/s41598-021-95202-4