Update on benign convulsions with mild gastroenteritis

Abstract

Benign convulsions with mild gastroenteritis (CwG) are characterized by afebrile convulsions associated with viral gastroenteritis in previously healthy infants and children. The main causative pathogens are rotavirus and norovirus. CwG occurs frequently in both East Asian and Western countries. The prevalence of CwG was reportedly not decreased by the introduction of rotavirus vaccines, and the prevalence of norovirus-associated CwG has been increasing annually. Convulsions in CwG are usually clustered, do not last longer than 5 minutes, and are mostly generalized. Laboratory diagnostics, electroencephalography (EEG), and imaging findings are usually normal. There is a probability of mild, transient abnormal findings on EEG or imaging limited to the acute disease phase. Although several reports have suggested that pathogens that affect the central nervous system through direct or indirect mechanisms could be related to the pathophysiology of CwG, its mechanism is not fully understood. Several antiepileptic drugs are effective during convulsions; however, long-term antiepileptic treatment is not required as CwG usually has a good prognosis.

Epidemiology, Clinical Features, and Unusual Complications of Norovirus Infection in Taiwan: What We Know after Rotavirus Vaccines

“…CwG is characterized by afebrile convulsions within 5 days of acute viral gastroenteritis in previously healthy infants and children between the ages of 6 months and 3 years without electrolyte balance or abnormal blood sugar level or abnormal result of cerebrospinal fluid analysis. Several reports have broadened the range of definitions for children aged <6 years with CwG [103,104,[109][110][111][112][113][114]. Convulsions in CwG are mostly generalized, usually clustered, and last less than 5 min.…”

“…Convulsions in CwG are mostly generalized, usually clustered, and last less than 5 min. Although clustering seizures frequently occur in the acute phase of CwG, the prognosis is good and long-term treatment is usually not required [109].…”

Epilepsy and the gut: Perpetrator or victim?

“…It occurs in young children with an immature nervous system, like febrile convulsions[ 53 ]. Unfortunately, the prevalence of this type of convulsion is on the rise and has not been affected by the introduction of the rotavirus vaccination[ 54 ]. The etiology and pathophysiology are not yet thoroughly explained.…”

Risk factors for recurrence of benign convulsions with mild gastroenteritis in children: A prospective cohort study

“…'Benign convulsions with mild gastroenteritis' (CwG) are defined as convulsions in children with viral gastroenteritis in the absence of severe dehydration, electrolyte or metabolic disturbances. 1 Although first reported by Morooka et al in 1982, the pathogenesis and course of CwG is still not well-defined. 1,2 To date, CwG is not formally recognised by the International League Against Epilepsy.…”

“…1 Although first reported by Morooka et al in 1982, the pathogenesis and course of CwG is still not well-defined. 1,2 To date, CwG is not formally recognised by the International League Against Epilepsy. However, it is generally considered to be a benign situation-related seizure rather than epilepsy.…”