Febrile and afebrile seizures associated with mild acute gastroenteritis in childhood

Abstract

Introduction. Seizures associated with mild acute gastroenteritis are very common in early childhood. The aim of this study is to provide basic information about seizures associated with acute gastroenteritis in order to distinguish these two entities and contribute to proper diagnosis and treatment. Material and Methods. Data were collected retrospectively from the medical records of consecutive children admitted to the Pediatric Clinic due to seizures associated with mild acute gastroenteritis in the period from October 2021 to April 2022. Patients were divided into two groups: febrile and afebrile. We compared the demographic and clinical characteristics of these two groups, as well as the microbiological, neurophysiological and neuroradiological characteristics. Results. Of the children with acute gastroenteritis and seizures, 11 were afebrile and 20 were febrile, with male predominance. The most frequently identified enteropathogen was rotavirus. Most patients presented with generalized seizures. The comparison of febrile and afebrile patients showed that cluster seizures were more common in the afebrile group (p < 0.05). Seven patients had a seizure that lasted longer than 5 minutes and all of them were from the febrile group (p < 0.01). All patients presented with normal neuroimaging findings. Conclusion. In clinical settings, making a distinction between febrile and afebrile gastroenteritis-related seizures as separate entities can be very difficult. It is still unclear what effect fever has on the onset of gastroenteritis- associated seizures, and whether febrile and afebrile seizures have a distinctly different pathophysiological mechanism, which is why further research is needed.