Alberto Verrotti1, Romina Moavero2, Federico Vigevano3, Laura Cantonetti3, Azzurra Guerra4, Elisabetta Spezia4, Antonella Tricarico4, Giuliana Nanni5, Sergio Agostinelli5, Francesco Chiarelli5, Pasquale Parisi6, Giuseppe Capovilla7, Francesca Beccaria7, Alberto Spalice8, Giangennaro Coppola9, Emilio Franzoni10, Valentina Gentile10, Susanna Casellato11, Pierangelo Veggiotti12, Sara Malgesini12, Giovanni Crichiutti13, Paolo Balestri14, Salvatore Grosso14, Nelia Zamponi15, Gemma Incorpora16, Salvatore Savasta17, Paola Costa18, Dario Pruna19, Raffaella Cusmai3. 1. Department of Pediatrics, University of Perugia, Perugia, Italy. Electronic address: alberto.verrottidipianella@unipg.it. 2. Systems Medicine Department, Child Neurology Unit, Tor Vergata University Hospital of Rome, Italy. 3. Neuroscience Department, Pediatric Neurology Unit, "Bambino Gesù" Children's Hospital, IRCCS, Rome, Italy. 4. Pediatric Neurology, Azienda Policlinico Modena, Modena, Italy. 5. Department of Pediatrics, University of Chieti, Chieti, Italy. 6. Chair of Pediatrics, II Faculty of Medicine, "La Sapienza" University of Rome, Rome, Italy. 7. Epilepsy Center, Department of Child Neuropsychiatry, C. Poma Hospital, Mantova, Italy. 8. Department of Pediatrics, "La Sapienza" University of Rome, Italy. 9. Department of Child Neuropsychiatry, University of Salerno, Salerno, Italy. 10. Department of Child Neuropsychiatry, University of Bologna, Bologna, Italy. 11. Department of Child Neuropsychiatry, University of Sassari, Italy. 12. Department of Child Neuropsychiatry, Child EEG Unit, Foundation C. Mondino Institute of Neurology, Pavia, Italy. 13. Department of Pediatrics, DPMSC, University of Udine, Italy. 14. Department of Pediatrics, University of Siena, Italy. 15. Department of Child Neuropsychiatry, University of Ancona, Italy. 16. Department of Pediatrics, Hospital of Ragusa, Italy. 17. Department of Pediatrics, University of Pavia, Italy. 18. Department of Child Neuropsychiatry, IRCCS Burlo Garofalo, Trieste, Italy. 19. Division of Child Neurology and Psychiatry, Azienda Ospedaliero-Universitaria Cagliari, Italy.
Abstract
BACKGROUND: The outcome of benign convulsions associated with gastroenteritis (CwG) has generally been reported as being excellent. However, these data need to be confirmed in studies with longer follow-up evaluations. AIM: To assess the long-term neurological outcome of a large sample of children presenting with CwG. METHODS: We reviewed clinical features of 81 subjects presenting with CwG (1994-2010) from three different Italian centers with a follow-up period of at least 3 years. RESULTS: Follow-up period ranged from 39 months to 15 years (mean 9.8 years). Neurological examination and cognitive level at the last evaluation were normal in all the patients. A mild attention deficit was detected in three cases (3.7%). Fourteen children (17.3%) received chronic anti-epileptic therapy. Interictal EEG abnormalities detected at onset in 20 patients (24.7%) reverted to normal. Transient EEG epileptiform abnormalities were detected in other three cases (3.7%), and a transient photosensitivity in one (1.2%). No recurrence of CwG was observed. Three patients (3.7%) presented with a febrile seizure and two (2.5%) with an unprovoked seizure, but none developed epilepsy. CONCLUSIONS: The long-term evaluation of children with CwG confirms the excellent prognosis of this condition, with normal psychomotor development and low risk of relapse and of subsequent epilepsy.
BACKGROUND: The outcome of benign convulsions associated with gastroenteritis (CwG) has generally been reported as being excellent. However, these data need to be confirmed in studies with longer follow-up evaluations. AIM: To assess the long-term neurological outcome of a large sample of children presenting with CwG. METHODS: We reviewed clinical features of 81 subjects presenting with CwG (1994-2010) from three different Italian centers with a follow-up period of at least 3 years. RESULTS: Follow-up period ranged from 39 months to 15 years (mean 9.8 years). Neurological examination and cognitive level at the last evaluation were normal in all the patients. A mild attention deficit was detected in three cases (3.7%). Fourteen children (17.3%) received chronic anti-epileptic therapy. Interictal EEG abnormalities detected at onset in 20 patients (24.7%) reverted to normal. Transient EEG epileptiform abnormalities were detected in other three cases (3.7%), and a transient photosensitivity in one (1.2%). No recurrence of CwG was observed. Three patients (3.7%) presented with a febrile seizure and two (2.5%) with an unprovoked seizure, but none developed epilepsy. CONCLUSIONS: The long-term evaluation of children with CwG confirms the excellent prognosis of this condition, with normal psychomotor development and low risk of relapse and of subsequent epilepsy.