Splenial Lesions in Benign Convulsions With Gastroenteritis Associated With Rotavirus Infection - 23/07/20

Doi : 10.1016/j.pediatrneurol.2019.05.002

Chikako Ogawa, MD, PhD ^a, Hiroyuki Kidokoro, MD, PhD ^a,^b, Naoko Ishihara, MD, PhD ^c, Takeshi Tsuji, MD, PhD ^d, Hirokazu Kurahashi, MD, PhD ^e, Ayako Hattori, MD, PhD ^f, Motomasa Suzuki, MD, PhD ^g, Shunsuke Ogaya, MD ^h, Yuji Ito, MD, PhD ^a, Tatsuya Fukasawa, MD ⁱ, Tetsuo Kubota, MD, PhD ⁱ, Akihisa Okumura, MD, PhD ^e, Shinji Saitoh, MD, PhD ^f, Jun Natsume, MD, PhD ^a,^b,^j,^⁎
^a Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
^b Brain and Mind Research Center, Nagoya University, Nagoya, Japan
^c Department of Pediatrics, Fujita Health University, Toyoake, Japan
^d Department of Pediatrics, Okazaki City Hospital, Okazaki, Japan
^e Department of Pediatrics, Aichi Medical University, Nagakute, Japan
^f Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
^g Department of Neurology, Aichi Children's Health and Medical Center, Obu, Japan
^h Department of Pediatrics, Japanese Red Cross Nagoya Daiichi Hospital, Nagoya, Japan
ⁱ Department of Pediatrics, Anjo Kosei Hospital, Anjo, Japan
^j Department of Developmental Disability Medicine, Nagoya University Graduate School of Medicine, Nagoya, Japan

^∗Communications should be addressed to: Natsume; Department of Pediatrics, Nagoya University Graduate School of Medicine 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan.Department of PediatricsNagoya University Graduate School of Medicine65 Tsurumai-cho, Showa-ku, NagoyaAichi466-8550Japan

Abstract

Objective

To investigate clinical risk factors for acute magnetic resonance imaging (MRI) abnormalities in patients with benign convulsions with mild gastroenteritis or benign infantile epilepsy.

Study design

We investigated clinical and diffusion-weighted imaging findings in 32 patients with benign convulsions with mild gastroenteritis and 22 patients with benign infantile epilepsy who underwent MRI within seven days of seizure onset between 2010 and 2015.

Results

Diffusion-weighted imaging showed signal hyperintensity in the splenium of the corpus callosum in seven patients with benign convulsions with mild gastroenteritis, but no abnormalities in patients with benign infantile epilepsy. Patients with benign convulsions with mild gastroenteritis with splenial lesions showed a higher rate of rotavirus detection from feces (P = 0.006), higher serum level of C-reactive protein (P = 0.04), and shorter interval between seizure onset and MRI (P = 0.002) than patients with benign convulsions with mild gastroenteritis without splenial lesions. Multivariate analysis revealed rotavirus infection as a significant risk factor for splenial lesions on diffusion-weighted imaging in patients with benign convulsions with mild gastroenteritis (P = 0.02).

Conclusions

Splenial lesions are often seen during acute period in patients with benign convulsions with mild gastroenteritis. Rotavirus infection is a risk factor for splenial lesions in patients with benign convulsions with mild gastroenteritis, suggesting the role of rotavirus to cause edema in the corpus callosum. From our observations, benign convulsions with mild gastroenteritis with a splenial lesion on diffusion-weighted imaging suggests good outcomes, and extensive evaluation of these patients may be unnecessary.

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Keywords : Diffusion-weighted imaging, Benign convulsions with mild gastroenteritis, Benign infantile epilepsy, Mild encephalitis or encephalopathy with reversible splenial lesion, Rotavirus infection

Plan

Introduction

Materials and methods

Standard protocol approvals, registrations, and patient consents

Patient recruitment

Clinical and imaging findings

Statistical methods

Results

Difference of clinical and MRI findings and treatments between patients with CwG and BIE

DWI abnormalities in patients with CwG

Clinical findings and treatments in patients with CwG and splenial lesion

Risk factors for splenial lesions in patients with CwG

Discussion

	Conflict of interest and disclosure: The authors have no conflicts of interest to disclose.
	Funding: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Splenial Lesions in Benign Convulsions With Gastroenteritis Associated With Rotavirus Infection - 23/07/20

Abstract

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