Benign Convulsions with Mild Gastroenteritis—An Underestimated Phenomenon?
Abstract
How often do you diagnose benign convulsions with mild gastroenteritis (CwG) in your patients? In Europe, we rarely consider this entity. Though cases in all ethnicities have been described, CwG predominantly affects childrenwith East Asian ethnicity,with large case series published since itsfirst description in 1982 by Morooka in Japan.1 The condition is clinically characterized by convulsions accompanying symptoms ofmild diarrhea without moderate to severe dehydration, without electrolyte imbalance, without hypoglycemia, and without fever before and after the seizure in a previously healthy infant orchild.Meningitisandencephalitisalsoneedtoberuledout.2,3 No single underlying infectious agent has been identified, CwG can complicate gastroenteritis caused by rotavirus, norovirus, or other viruses. In a fewpatients, focal epileptiformdischarges have been described on interictal electroencephalogram.4 Recurrent seizures frequently are observed during the acute illness,1 while follow-up shows no increased risk for development of epilepsy. As yet, no underlying genetic factors or consistently associated biomarkers have been found, though recentlyelevateduricacidhasbeendescribedinsomepatients.5 If patients suffer repeated seizures during a gastroenteritis, antiseizure medication may be indicated. In a small cohort, possible efficacy of phenobarbital to prevent further seizures has recently been demonstrated.6 In this issue, Su Jeong You reports on a large cohort of…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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