Benign convulsions in children with mild gastroenteritis

• Enteric viruses may have a role in benign convulsions with mild gastroenteritis (CwG).
• An immature central nervous system may increase the risk of CwG.
• Specific genetic characteristics seem associated with CwG.
• Diagnostic examinations are usually normal in patients with CwG.
• Only prolonged seizures require antiepileptic treatments.

BackgroundBenign convulsions with mild gastroenteritis (CwG) is a clinical condition characterized by convulsions occurring in otherwise healthy children, usually in the absence of fever and in the presence of mild acute gastroenteritis. Until now, CwG had not been fully recognized as an epileptic syndrome, and several aspects of this condition are not clearly defined, especially its pathogenesis.MethodsThe main aim of this paper is to discuss after the review of the literature what is known about CwG to facilitate its recognition and treatment.ResultsCwG is a benign condition that has several clinical and prognostic similarities with febrile seizures. The disease occurs in infants and in children who are 1 month to 3 years old, during the winter and early spring when rotavirus and norovirus are circulating. In most cases, seizures follow gastrointestinal symptoms. In a minority of patients, the seizures and gastrointestinal symptoms occur before or simultaneously with the development of diarrhoea. Even if convulsions are mostly described as generalized tonic-clonic, the ictal recordings have always demonstrated a focal origin. Electroencephalography, lumbar punctures, and radiological examinations are not useful because they are normal in these patients; and when alterations are present, they disappear in a relatively short time. Only prolonged seizures, which are usually not common, require antiepileptic treatments in the acute phase.ConclusionKnowledge of CwG characteristics is essential for paediatricians to avoid useless hospitalization, examinations and, above all, drug administration, as the drugs have potential side effects.