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目的:研究轻度胃肠炎伴良性婴幼儿惊厥(BICE)的临床特点以指导临床治疗。方法:对2009年1月至2010年6月乌鲁木齐市儿童医院神经内科病房收治的21例BICE患儿的临床资料和出院后24～42月的随访结果进行回顾性分析。结果:21例BICE患儿男女比例为1∶0.62;年龄8～26个月,其中12～24个月16例(76.2%)。发病季节9-11月份高发。惊厥发生时间无热惊厥后24 h内出现急性胃肠炎(BE)者3例,在急性胃肠炎后第1～5天出现惊厥18例,以3 d内最多(76.1%)。13例(61.9%)出现2次以上惊厥,平均发作次数为2.1次,9次惊厥因疼痛哭闹所诱发(20.5%),惊厥持续时间40 s～3 min,无惊厥持续状态,发作形式为全面强直-阵挛发作。4例有热性惊厥家族史。发作间期监测V-EEG,3例睡眠期见两枕部、中央区低-中波幅不典型尖慢波散发,5例见睡眠纺锤波及慢波改变,3例头颅CT示外部性脑积水,其余未见异常。13例(61.9%)大便轮状病毒抗原阳性,8例阴性。出院后18例进行24～42个月随访,无1例复发,精神运动发育正常。结论:BICE 1～2岁发病率高,以秋冬季多见。轮状病毒为主要病因,部分患儿有热性惊厥家族史。惊厥多发生在急性胃肠炎病程1～3 d,早期频繁发作,但无惊厥持续状态,发作形式为全身强直-阵挛发作,发作间期EEG及头颅影像学正常。预后良好。
Objective: To study the clinical features of mild gastroenteritis with benign infantile convulsions (BICE) to guide the clinical treatment. Methods: The clinical data of 21 cases of BICE admitted to Urology Department of Children’s Hospital of Urumqi from January 2009 to June 2010 and the follow-up results from 24 to 42 months after discharge were analyzed retrospectively. Results: The ratio of male to female in 21 cases of BICE was 1: 0.62. The age ranged from 8 to 26 months, of which 16 cases (76.2%) were from 12 to 24 months. The onset of the season from September to November high incidence. There were 3 cases of acute gastroenteritis (BE) within 24 h after onset of seizure, 18 cases of seizures from 1 to 5 days after acute gastroenteritis (up to 76.1% within 3 d). 13 cases (61.9%) had more than 2 convulsions, the average number of seizures was 2.1 times, 9 seizures induced by painful crying (20.5%), convulsions duration of 40 s ~ 3 min, no convulsions sustained state of attack was Total Tonic-Clonic Attack. 4 cases had a family history of febrile seizures. Seizure interval monitoring V-EEG, three cases of occipital see the occipital sleep, central low-to-medium amplitude of the typical sharp slow wave emission, 5 cases of sleep spindles and slow wave changes, 3 cases of cranial CT showed external hydrocephalus , The rest without exception. 13 cases (61.9%) stool rotavirus antigen positive, 8 cases were negative. 18 cases were discharged after 24 to 42 months of follow-up, no recurrence, normal mental development. Conclusion: BICE 1 ~ 2 years old with high incidence, more common in autumn and winter. Rotavirus is the main cause, and some children have a family history of febrile seizures. Convulsions occurred in the course of acute gastroenteritis 1 ~ 3 d, frequent episodes of early, but no convulsive persistence state, the onset of the form of tonic-clonic seizures, interictal EEG and cranial imaging normal. The prognosis is good.