Comparison of clinical features between benign convulsions with mild gastroenteritis and febrile seizures with gastroenteritis

QIU Xiaoying; ZENG Yongmei; ZHANG Jiyong; XIAO Fei; HAO Jindou; LI Weiyan; WANG Yuanyuan; CHEN Youyan; ZENG Fanfei; DONG Guoqing

doi:10.3969/j.issn.1674-3806.2025.03.06

Abstract：Objective To compare the clinical features between benign convulsions with mild gastroenteritis(CwG)and febrile seizure with gastroenteritis(FSwG)in pediatric patients,and to provide the basis for early assessment and management of CwG.Methods The clinical data of 99 pediatric patients aged 1-72 months who were hospitalized in Department of Pediatrics,Shenzhen Maternity and Child Healthcare Hospital,Southern Medical University for acute gastroenteritis or convulsion with diarrhea from January 2018 to December 2021 were retrospectively collected.According to the body temperature before and after convulsion,the pediatric patients were divided into CwG group(no fever or body temperature＜38℃,67 cases)and FSwG group(body temperature ≥38 ℃,32 cases).The clinical data and outcomes were compared between the two groups.Results There were no significant differences in age and gender composition between the two groups,but the onset time of the CwG group was more concentrated in the age of＞12-24 months.CwG tended to occur in autumn and winter,while FSwG tended to occur in winter and spring.The proportion of seizure clusters in the CwG group was significantly higher than that in the FSwG group(46.27％ vs 6.25％,P＜0.05).The seizures in the CwG group were more likely to occur at＞24-48 hours after gastroenteritis symptoms,and the occurrence of seizures in the CwG group was significantly later than that in the FSwG group[(1.94±0.92)d vs(1.34±0.74)d,P＜0.05].The levels of C-reactive protein(CRP),procalcitonin(PCT),prealbumin(PAB)and HCO3-in the CwG group were lower than those in the FSwG group,while the levels of alanine aminotransferase(ALT),uric acid(UA)and creatine kinase isoenzyme MB(CK-MB)in the CwG group were higher than those in the FSwG group,with statistically significant differences between the two groups(P＜0.05).There were no obvious abnormalities in the pediatric patients'acute stage electroencephalogram(EEG)and skull imaging examination in the two groups.After follow-up of 18 months to 5 years,12 cases in the CwG group were lost,and 1 case of the other 55 cases had the recurrence of gastroenteritis without febrile seizures.In the FSwG group,4 cases were lost to follow-up,and 5 cases of the other 28 cases had the recurrence of febrile seizures.Conclusion CwG is a benign disease that tends to occur in pediatric patients aged 1 to 2 years and is common in autumn and winter,with a tendency to seizure clusters,generally with good prognosis and rarely relapses.When the likelihood of CwG is considered to be high clinically,cerebrospinal fluid examination,skull imaging examination and anticonvulsant therapy may not be necessary even in the acute phase of seizure clusters.