title: Clinical Epidemiology and Treatment of Febrile and Afebrile Convulsions With Mild Gastroenteritis: A Multicenter Study.
abstract: We investigated features and responses to treatment in patients with febrile and afebrile convulsions with mild gastroenteritis and characterized convulsions with rotavirus and norovirus gastroenteritis.
  
  
  
  We conducted a prospective, observational study to evaluate patients with febrile and afebrile convulsions with mild gastroenteritis who were hospitalized between November 2011 and March 2014 at 13 facilities in the National Hospital Organization. We classified the patients into two groups: presence or absence of fever. We investigated the background, clinical and laboratory characteristics, viral antigen in stool, and efficacy of anticonvulsant drugs.
  
  
  
  Of 126 patients enrolled in this study, 50 were febrile (Fc group) and 76 were afebrile (aFc group). A family history of febrile seizures was significantly more frequent in the Fc group than in the aFc group (28.0% vs 9.2%, P = 0.005). Clinical characteristics were similar between the rotavirus and norovirus groups, but fever was significantly more frequent in the rotavirus group (46.2% vs 8.3%, P < 0.001). Serum sodium levels were significantly negatively related to the number of seizures in the aFc group (β = -0.13; 95% confidence interval, -0.24, -0.03; P = 0.01). Carbamazepine was significantly more efficacious than diazepam suppositories in the aFc group (odds ratio = 49.3, 95% confidence interval, 2.35, 1037; P = 0.01).
  
  
  
  Febrile convulsions with mild gastroenteritis show characteristics of both febrile seizures and convulsions with mild gastroenteritis. Carbamazepine is optimal for convulsions with mild gastroenteritis. Clinical features of convulsions with rotavirus and norovirus gastroenteritis are similar, except for fever. Serum sodium levels may play a major role in the onset of convulsions with mild gastroenteritis.
authors.affiliation: Department of Pediatrics, National Hospital Organization Okayama Medical Center, Okayama, Okayama, Japan; Department of Pediatrics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Okayama, Japan.
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Higuchi
authors.affiliation: Department of Pediatrics, National Hospital Organization Okayama Medical Center, Okayama, Okayama, Japan. Electronic address: kubocchi@okayamamc.jp.
authors.forename: Toshihide
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Mitsuhashi
authors.affiliation: Department of Pediatrics, National Hospital Organization Shikoku Medical Center for Children and Adults, Zentsuji, Kagawa, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Nakamura
authors.affiliation: Department of Pediatrics, National Hospital Organization Shikoku Medical Center for Children and Adults, Zentsuji, Kagawa, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Yokota
authors.affiliation: Department of Pediatrics, National Hospital Organization Tokyo Medical Center, Meguro-ku, Tokyo, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Komiyama
authors.affiliation: Department of Pediatrics, Saitama National Hospital, Wako, Saitama, Japan.
authors.forename: Isamu
authors.initials: I
authors.lastname: Kamimaki
authors.affiliation: Department of Pediatrics, National Hospital Organization Shimoshizu Hospital, Yotsukaido, Chiba, Japan.
authors.forename: Shigenori
authors.initials: S
authors.lastname: Yamamoto
authors.affiliation: Department of Pediatrics, National Hospital Organization Nagara Medical Center, Gifu, Gifu, Japan.
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Uchida
authors.affiliation: Department of Pediatrics, National Hospital Organization Kokura Medical Center, Kitakyushu, Fukuoka, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Watanabe
authors.affiliation: Department of Pediatrics, National Hospital Organization Kokura Medical Center, Kitakyushu, Fukuoka, Japan.
authors.forename: Hironori
authors.initials: H
authors.lastname: Yamashita
authors.affiliation: Department of Pediatrics, National Hospital Organization Miechuo Medical Center, Tsu, Mie, Japan.
authors.forename: Shigeki
authors.initials: S
authors.lastname: Tanaka
authors.affiliation: Department of Pediatrics, Mie National Hospital, Tsu, Mie, Japan.
authors.forename: Kosei
authors.initials: K
authors.lastname: Iguchi
authors.affiliation: Department of Pediatrics, Mie National Hospital, Tsu, Mie, Japan.
authors.forename: Ryouji
authors.initials: R
authors.lastname: Ichimi
authors.affiliation: Department of Pediatrics, National Hospital Organization Kure Medical Center and Chugoku Cancer Center, Kure, Hiroshima, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Miyagawa
authors.affiliation: Department of Pediatrics, National Hospital Organization Saga National Hospital, Saga, Saga, Japan.
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Takayanagi
authors.affiliation: Department of Pediatrics, National Hospital Organization Beppu Medical Center, Beppu, Oita, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Koga
authors.affiliation: Department of Pediatrics, National Hospital Organization Sagamihara National Hospital, Sagamihara, Kanagawa, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Shukuya
authors.affiliation: Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya Clinical Research Center, Nagoya, Aichi, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Saito
authors.affiliation: Clinical Research Center, National Hospital Organization Nagoya Medical Center, Nagoya Clinical Research Center, Nagoya, Aichi, Japan.
authors.forename: Keizo
authors.initials: K
authors.lastname: Horibe
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D002220:Carbamazepine / Q000627:therapeutic use; D003975:Diazepam / Q000627:therapeutic use; D005260:Female; D005334:Fever / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology* / Q000821:virology; D005759:Gastroenteritis / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology* / Q000821:virology; D006801:Humans; D007223:Infant; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D011446:Prospective Studies; D012640:Seizures / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology* / Q000821:virology; D012964:Sodium / Q000097:blood; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine; D012964:Sodium; D003975:Diazepam
keywords: carbamazepine; convulsions with mild gastroenteritis; febrile seizure; norovirus; rotavirus