Clinical Epidemiology and Treatment of Febrile and Afebrile Convulsions With Mild Gastroenteritis

A Multicenter Study

Yousuke Higuchi, Toshihide Kubo, Toshiharu Mitsuhashi, Naoko Nakamura, Ichiro Yokota, Osamu Komiyama, Isamu Kamimaki, Shigenori Yamamoto, Yasushi Uchida, Kyoko Watanabe, Hironori Yamashita, Shigeki Tanaka, Kosei Iguchi, Ryouji Ichimi, Shinichiro Miyagawa, Toshimitsu Takayanagi, Hiroshi Koga, Akinori Shukuya, Akiko Saito, Keizo Horibe

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background We investigated features and responses to treatment in patients with febrile and afebrile convulsions with mild gastroenteritis and characterized convulsions with rotavirus and norovirus gastroenteritis. Methods We conducted a prospective, observational study to evaluate patients with febrile and afebrile convulsions with mild gastroenteritis who were hospitalized between November 2011 and March 2014 at 13 facilities in the National Hospital Organization. We classified the patients into two groups: presence or absence of fever. We investigated the background, clinical and laboratory characteristics, viral antigen in stool, and efficacy of anticonvulsant drugs. Results Of 126 patients enrolled in this study, 50 were febrile (Fc group) and 76 were afebrile (aFc group). A family history of febrile seizures was significantly more frequent in the Fc group than in the aFc group (28.0% vs 9.2%, P = 0.005). Clinical characteristics were similar between the rotavirus and norovirus groups, but fever was significantly more frequent in the rotavirus group (46.2% vs 8.3%, P < 0.001). Serum sodium levels were significantly negatively related to the number of seizures in the aFc group (β = −0.13; 95% confidence interval, −0.24, −0.03; P = 0.01). Carbamazepine was significantly more efficacious than diazepam suppositories in the aFc group (odds ratio = 49.3, 95% confidence interval, 2.35, 1037; P = 0.01). Conclusion Febrile convulsions with mild gastroenteritis show characteristics of both febrile seizures and convulsions with mild gastroenteritis. Carbamazepine is optimal for convulsions with mild gastroenteritis. Clinical features of convulsions with rotavirus and norovirus gastroenteritis are similar, except for fever. Serum sodium levels may play a major role in the onset of convulsions with mild gastroenteritis.

Original languageEnglish
Pages (from-to)78-84
Number of pages7
JournalPediatric Neurology
Volume67
DOIs
Publication statusPublished - Feb 1 2017

Fingerprint

Febrile Seizures
Gastroenteritis
Multicenter Studies
Epidemiology
Rotavirus
Seizures
Norovirus
Fever
Carbamazepine
Therapeutics
Sodium
Confidence Intervals
Suppositories
Viral Antigens
Diazepam
Serum
Anticonvulsants
Observational Studies
Odds Ratio
Organizations

Keywords

  • carbamazepine
  • convulsions with mild gastroenteritis
  • febrile seizure
  • norovirus
  • rotavirus

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Neurology
  • Developmental Neuroscience
  • Clinical Neurology

Cite this

Clinical Epidemiology and Treatment of Febrile and Afebrile Convulsions With Mild Gastroenteritis : A Multicenter Study. / Higuchi, Yousuke; Kubo, Toshihide; Mitsuhashi, Toshiharu; Nakamura, Naoko; Yokota, Ichiro; Komiyama, Osamu; Kamimaki, Isamu; Yamamoto, Shigenori; Uchida, Yasushi; Watanabe, Kyoko; Yamashita, Hironori; Tanaka, Shigeki; Iguchi, Kosei; Ichimi, Ryouji; Miyagawa, Shinichiro; Takayanagi, Toshimitsu; Koga, Hiroshi; Shukuya, Akinori; Saito, Akiko; Horibe, Keizo.

In: Pediatric Neurology, Vol. 67, 01.02.2017, p. 78-84.

Research output: Contribution to journalArticle

Higuchi, Y, Kubo, T, Mitsuhashi, T, Nakamura, N, Yokota, I, Komiyama, O, Kamimaki, I, Yamamoto, S, Uchida, Y, Watanabe, K, Yamashita, H, Tanaka, S, Iguchi, K, Ichimi, R, Miyagawa, S, Takayanagi, T, Koga, H, Shukuya, A, Saito, A & Horibe, K 2017, 'Clinical Epidemiology and Treatment of Febrile and Afebrile Convulsions With Mild Gastroenteritis: A Multicenter Study', Pediatric Neurology, vol. 67, pp. 78-84. https://doi.org/10.1016/j.pediatrneurol.2016.05.011
Higuchi, Yousuke ; Kubo, Toshihide ; Mitsuhashi, Toshiharu ; Nakamura, Naoko ; Yokota, Ichiro ; Komiyama, Osamu ; Kamimaki, Isamu ; Yamamoto, Shigenori ; Uchida, Yasushi ; Watanabe, Kyoko ; Yamashita, Hironori ; Tanaka, Shigeki ; Iguchi, Kosei ; Ichimi, Ryouji ; Miyagawa, Shinichiro ; Takayanagi, Toshimitsu ; Koga, Hiroshi ; Shukuya, Akinori ; Saito, Akiko ; Horibe, Keizo. / Clinical Epidemiology and Treatment of Febrile and Afebrile Convulsions With Mild Gastroenteritis : A Multicenter Study. In: Pediatric Neurology. 2017 ; Vol. 67. pp. 78-84.
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T2 - A Multicenter Study

AU - Higuchi, Yousuke

AU - Kubo, Toshihide

AU - Mitsuhashi, Toshiharu

AU - Nakamura, Naoko

AU - Yokota, Ichiro

AU - Komiyama, Osamu

AU - Kamimaki, Isamu

AU - Yamamoto, Shigenori

AU - Uchida, Yasushi

AU - Watanabe, Kyoko

AU - Yamashita, Hironori

AU - Tanaka, Shigeki

AU - Iguchi, Kosei

AU - Ichimi, Ryouji

AU - Miyagawa, Shinichiro

AU - Takayanagi, Toshimitsu

AU - Koga, Hiroshi

AU - Shukuya, Akinori

AU - Saito, Akiko

AU - Horibe, Keizo

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N2 - Background We investigated features and responses to treatment in patients with febrile and afebrile convulsions with mild gastroenteritis and characterized convulsions with rotavirus and norovirus gastroenteritis. Methods We conducted a prospective, observational study to evaluate patients with febrile and afebrile convulsions with mild gastroenteritis who were hospitalized between November 2011 and March 2014 at 13 facilities in the National Hospital Organization. We classified the patients into two groups: presence or absence of fever. We investigated the background, clinical and laboratory characteristics, viral antigen in stool, and efficacy of anticonvulsant drugs. Results Of 126 patients enrolled in this study, 50 were febrile (Fc group) and 76 were afebrile (aFc group). A family history of febrile seizures was significantly more frequent in the Fc group than in the aFc group (28.0% vs 9.2%, P = 0.005). Clinical characteristics were similar between the rotavirus and norovirus groups, but fever was significantly more frequent in the rotavirus group (46.2% vs 8.3%, P < 0.001). Serum sodium levels were significantly negatively related to the number of seizures in the aFc group (β = −0.13; 95% confidence interval, −0.24, −0.03; P = 0.01). Carbamazepine was significantly more efficacious than diazepam suppositories in the aFc group (odds ratio = 49.3, 95% confidence interval, 2.35, 1037; P = 0.01). Conclusion Febrile convulsions with mild gastroenteritis show characteristics of both febrile seizures and convulsions with mild gastroenteritis. Carbamazepine is optimal for convulsions with mild gastroenteritis. Clinical features of convulsions with rotavirus and norovirus gastroenteritis are similar, except for fever. Serum sodium levels may play a major role in the onset of convulsions with mild gastroenteritis.

AB - Background We investigated features and responses to treatment in patients with febrile and afebrile convulsions with mild gastroenteritis and characterized convulsions with rotavirus and norovirus gastroenteritis. Methods We conducted a prospective, observational study to evaluate patients with febrile and afebrile convulsions with mild gastroenteritis who were hospitalized between November 2011 and March 2014 at 13 facilities in the National Hospital Organization. We classified the patients into two groups: presence or absence of fever. We investigated the background, clinical and laboratory characteristics, viral antigen in stool, and efficacy of anticonvulsant drugs. Results Of 126 patients enrolled in this study, 50 were febrile (Fc group) and 76 were afebrile (aFc group). A family history of febrile seizures was significantly more frequent in the Fc group than in the aFc group (28.0% vs 9.2%, P = 0.005). Clinical characteristics were similar between the rotavirus and norovirus groups, but fever was significantly more frequent in the rotavirus group (46.2% vs 8.3%, P < 0.001). Serum sodium levels were significantly negatively related to the number of seizures in the aFc group (β = −0.13; 95% confidence interval, −0.24, −0.03; P = 0.01). Carbamazepine was significantly more efficacious than diazepam suppositories in the aFc group (odds ratio = 49.3, 95% confidence interval, 2.35, 1037; P = 0.01). Conclusion Febrile convulsions with mild gastroenteritis show characteristics of both febrile seizures and convulsions with mild gastroenteritis. Carbamazepine is optimal for convulsions with mild gastroenteritis. Clinical features of convulsions with rotavirus and norovirus gastroenteritis are similar, except for fever. Serum sodium levels may play a major role in the onset of convulsions with mild gastroenteritis.

KW - carbamazepine

KW - convulsions with mild gastroenteritis

KW - febrile seizure

KW - norovirus

KW - rotavirus

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