Percorsi clinici
Convulsioni e gastroenterite: un caso che insegna
A case of convulsions with gastroenteritis
Chiara Del Bono1, Federica Ciambrelli1, Alessandro Rocca2, Luca Pierantoni2, Monia Gennari2, Marcello Lanari2
1Scuola di Specializzazione in Pediatria, Alma Mater Studiorum, Università di Bologna
2UO di Pediatria d’Urgenza, IRCCS Azienda Ospedaliero-Universitaria, Policlinico di Sant’Orsola, Bologna
Novembre 2022 - pagg. 589 -592 | DOI: 10.53126/MEB41589
Abstract
The article reports a case of convulsions with gastroenteritis (CWG) and briefly reviews the related literature. A 2-year-old girl presented with four short episodes of focal afebrile seizures within 12 hours. She had fever with vomiting in the previous 2 days and she developed diarrhoea during her hospital stay, after the fifth seizure. She had no significant past medical history and showed neither neurological signs nor signs of dehydration. Serum electrolytes were normal, cerebrospinal fluid examination was negative for meningoencephalitis and contrast-enhanced CT Brain scan showed no evidence of intracranial lesion. Stool investigation was positive for rotavirus. Therefore, the diagnosis of CWG was made. Repeated convulsions were handled with continuous intravenous infusion of midazolam. The main cause of CWGs in viral gastroenteritis is due to rotavirus or norovirus. The convulsions are usually focal seizure clusters, with secondary generalization. CWGs are associated with a benign prognosis.
Riassunto
In questo articolo presentiamo un caso clinico di “convulsioni associate a gastroenterite” e la relativa revisione della letteratura. Il caso presentato è quello di una bambina di 2 anni, ricoverata nel nostro reparto per ripetute crisi convulsive in apiressia in corso di gastroenterite acuta (GEA). Le indagini di laboratorio e strumentali, effettuate sui versanti infettivologico e neurologico, hanno permesso di escludere meningite, encefalite virale e autoimmune, lesioni centrali di tipo neoplastico e ischemico-emorragico. Alla luce del quadro clinico e della positività della ricerca di rotavirus su feci, è stata posta la diagnosi di crisi convulsive in corso di gastroenterite. Le convulsioni ripetute sono state gestite con infusione endovenosa continua di midazolam. Tali episodi convulsivi sono associati a prognosi benigna, similmente a quanto accade per le convulsioni febbrili.
Parole chiave
Classificazione MeSH
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Corrispondenza: chiara.delbono@studio.unibo.it