Castellazzi Luca, Principi Nicola, Agostoni Carlo, Esposito Susanna
Pediatric Highly Intensive Care Unit, Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Pediatric Medium Intensity Care Unit, Department of Clinical Sciences and Community Health, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
Eur J Paediatr Neurol. 2016 Sep;20(5):690-5. doi: 10.1016/j.ejpn.2016.05.014. Epub 2016 May 27.
Benign convulsions with mild gastroenteritis (CwG) is a clinical condition characterized by convulsions occurring in otherwise healthy children, usually in the absence of fever and in the presence of mild acute gastroenteritis. Until now, CwG had not been fully recognized as an epileptic syndrome, and several aspects of this condition are not clearly defined, especially its pathogenesis.
The main aim of this paper is to discuss after the review of the literature what is known about CwG to facilitate its recognition and treatment.
CwG is a benign condition that has several clinical and prognostic similarities with febrile seizures. The disease occurs in infants and in children who are 1 month to 3 years old, during the winter and early spring when rotavirus and norovirus are circulating. In most cases, seizures follow gastrointestinal symptoms. In a minority of patients, the seizures and gastrointestinal symptoms occur before or simultaneously with the development of diarrhoea. Even if convulsions are mostly described as generalized tonic-clonic, the ictal recordings have always demonstrated a focal origin. Electroencephalography, lumbar punctures, and radiological examinations are not useful because they are normal in these patients; and when alterations are present, they disappear in a relatively short time. Only prolonged seizures, which are usually not common, require antiepileptic treatments in the acute phase.
Knowledge of CwG characteristics is essential for paediatricians to avoid useless hospitalization, examinations and, above all, drug administration, as the drugs have potential side effects.
轻度胃肠炎伴良性惊厥(CwG)是一种临床病症,其特征为在其他方面健康的儿童中出现惊厥,通常无发热且伴有轻度急性胃肠炎。迄今为止,CwG尚未被完全确认为一种癫痫综合征,该病症的几个方面尚未明确界定,尤其是其发病机制。
本文的主要目的是在回顾文献后讨论关于CwG的已知情况,以促进其识别和治疗。
CwG是一种良性病症,在临床和预后方面与热性惊厥有若干相似之处。该疾病发生于1个月至3岁的婴幼儿,在冬季和早春轮状病毒和诺如病毒传播时出现。在大多数情况下,惊厥发生在胃肠道症状之后。少数患者中,惊厥和胃肠道症状在腹泻出现之前或同时发生。即使惊厥大多被描述为全身性强直阵挛发作,但发作期记录始终显示为局灶性起源。脑电图、腰椎穿刺和影像学检查并无帮助,因为这些检查在这些患者中均正常;而当出现改变时,它们会在相对较短的时间内消失。只有持续时间较长的惊厥(通常并不常见)在急性期需要抗癫痫治疗。
了解CwG的特征对于儿科医生避免不必要的住院、检查,尤其是避免用药至关重要,因为药物有潜在的副作用。