Acute gastroenteritis related to low risk of seizure recurrence

Martin ET. Pediatrics. 2010;doi:10.1542/peds.2010-1138.

Children who had acute gastroenteritis at the time of their first seizure were less likely to have a seizure recurrence and had few neurological complications, according to researchers from Seattle Children’s Research Institute, the CDC and the University of Washington.

“[For parents and physicians of children having first-time seizures], the most salient concern once a child is stabilized regards the risk of recurrence,” the researchers wrote. “That risk has been well defined for febrile seizures, but remains poorly defined for nonfebrile seizures.”

Researchers studied children aged 6 months to 6 years who presented to the ED with a first-time seizure. They collected data on symptoms and also samples of serum, stool and cerebrospinal fluid from 117 children within 48 hours of the first seizure. Of the children, 67% had febrile first seizures, 29% had nonfebrile-illness first seizures and 4% had unprovoked first seizures. The children were followed monthly for up to 5 years.

Children who had nonfebrile seizures were more likely to have acute gastroenteritis: 47% compared with 28% of those who had febrile seizures. The stool samples of those children were also more likely to test positive for rotavirus and for norovirus.

There were no significant differences in seizure recurrence between children who had a fever and those who did not have a fever at the first seizure. The children who presented with acute gastroenteritis had a lower risk of seizure recurrence.

“Although the mechanism behind these seizures remains unclear, our results confirm the good prognosis and low risk of seizure recurrence for children who present with a first-time seizure associated with an acute gastrointestinal illness,” the researchers wrote.

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