Abstracts

Rationale: Benign convulsions associated with mild gastroenteritis (CwG) are a commonly observed disorder in infants and toddlers, known for association with rotavirus. We suggest that norovirus is a new culprit of CwG in korean children. Also compared the clinical characteristics of CwG between norovirus and rotavirus. Methods: All hospitalized patients for CwG at Korea University Guro Hospital were included during 5 consecutive months between Nov 2012 and Mar 2013. CwG was defined as follows: a) seizures accompanying symptoms of gastroenteritis without dehydration or electrolyte imbalance and b) body temperature remains below 38 Celcius at least 6 hours before and after the seizures. Stool specimens were tested for rotavirus, norovirus, and enteric adenovirus by RT-PCR. For comparison, CwG cases with positive stool test for rotavirus were also searched by chart review from 2008 to 2013. Results: Total 28 patients were included. Among them, causative diarrheal viruses were detected in 21 (87.5%) of the fecal specimens tested; 18 (69.4%) patients were positive for norovirus, 3 patients were positive for rotavirus. Total number of CwG cases associated with rotavirus during the past 5 years was 17. Comparing the demographics and clinical characteristics of those with norovirus and rotavirus, precedent febrile illness was more commonly observed in rotavirus cases (22.2% vs 75%, p=0.03). Also, the time latency from gastroenteritis to first seizure onset (p=0.00) and the duration of each seizure (p=0.00) were shorter in norovirus cases. No significant difference was noted in number of seizure episodes and time interval to final seizure. However, over 10 times of seizure episodes occurred for less than 12 hours in 2 cases with norovirus, which was impressive. IV anticonvulsants were used in some cases with no obvious effect. Conclusions: Our study shows that norovirus is a newly emerging culprit of CwG and also self-limited in less than 24 hours showing clinical differences with rotavirus at some point. Most of all, stool PCR for norovirus in addition to rotavirus could be useful for avoiding unnecessary antiepileptic treatment in suspected cases.