Neurological Manifestaions in Acute Onset of Viral Gastroentritis

Abstract

Back ground: AGE is one of the most common causes of morbidity and mortality in infants and children in developing countries with near 11,000 deaths per day in the world. Objective: To evaluate the prevalence of neurological manifestations in acute onset of viral gastrointestinal. Methods: A cross sectional /descriptive study performed upon 50 children admitted due to acute viral gastrointestinal infections in Department of pediatric Infectious Disease, Rasul Hospital, Tehran, Iran, 2010- 2011. Initially, a questionnaire was completed by an authorized physician for each cases (eg: age, gender, clinical signs, vomiting, diarrhea (type, time of onset, frequency) attending time from onset ,type of neurologic symptoms ,analysis of lab test (stool direct exams, biochemical parameters, stool culture, direct viral test in stool). All cases with bacterial or other known causes (except viral causes) for gastroenteritis, chronic diarrhea excluded from study. The studied cases were evaluated for existence of neurologic signs .Stool samples were searched for viral antigens (Rota & Adeno virus) by Rapid immune chromatographic test. P-values less than 0.05 were considered statistically significant. Results: Neurological manifestations observed in 16% of cases included seizure 12% aseptic meningitis 4%, 20% of adenoviral, 13.5% of rota virus and 33.3% of bi-infection had neurologic signs, with no differences (P=0.619). Mean age of cases had not significant difference between cases with and without neurologic manifestation. There was no significant association between neurological symptoms with age (P=0.755), sex, virus type and attending time (P>0.05). Conclusions: This study indicated that viral agents, especially rota virus can be obtained from near 60% of studied cases. Adenovirus (20%); Human Boca virus (8%) and other (undiagnosed) viral infection were less common causes. Neurological symptoms including seizure or aseptic meningitis might observe in 16% of children especially in cases with co-infection rota and adenoviral infection (33.3%) which is not related to age, sex and attending time. Rotavirus-associated encephalopathy described by some authors. Due to presence a safe and effective rotavirus vaccination, we prefer to routine usage of it as a public health priority in Iran. Further study is required to determine the role of rotavirus and other viral infection in diarrhea associated encephalopathy.