CONVULSION IN GASTEROENTERITIS OF CHILDRE

Annually from one billion gastroenteritis patients 3-5 million children die world wide. Etiologic agent in developed countries is viral in 15-60% of cases, while in developing countries bacteria and parasites are frequently reported as etiologic factors. Neurologic signs including convulsion are seen in some cases with diarrhea, which may be accompanied with or without fever and may have electrolyte imbalance. Convulsion with gastroenteritis is mostly benign, usually without changes in EEG or cerebrospinal fluid. Tabriz Children Hospital is a center for complicated cases of gastroenteritis including convulsion. This study aimed to investigate the etiology, risk factors and short term prognosis of gastroenteritis with convulsion. This descriptive-cross sectional study was done during three years in Tabriz Children Hospital and 50 children at the range of two months to seven years old having gastroenteritis with convulsion were enrolled into the case group. Equal number of children at the same range of age having gastroenteritis without convulsion were included in the control group. The case and control groups were matched considering age, sex, and duration of the study. Body temperature (BT), severity and type of dehydration, stool exams, cultures, history of convulsion in subjects and first degree relatives, electrolyte imbalances, and short term prognosis were studied. There was no significant difference between the groups regarding age, sex, and weight, while the fever at the time of admission, history of convulsion in first degree relatives and severity of dehydration were significantly higher in the case group (P<0.001). The BT of the case group at time of admission was higher than the control group (39.01±0.80 vs. 37.52±0.67 o C). Also the frequency of history of convulsion in the patients, shigellosis and antibiotic usage were significantly higher in the case group (P=0.025, P=0.014, and P=0.001 respectively). Convulsion mostly common in mild gastroenteritis accompanied with high fever and positive history of convulsion in the first degree relatives. The history of convulsion in the patients and shigellosis were causes of the relative increased occurrence of convulsion in patients with gastroenteritis. Electrolyte imbalance did not play a significant role in the development of convulsion.