Seizures and Encephalopathy as the Presenting Sign of Viral Gastroenteritis

Abstract

To determine the incidence, nature, and outcome of encephalopathy associated with viral gastroenteritis in hospitalized children. Retrospective chart review of all children during a 4-year period with viral gastroenteritis identified by International Classification of Diseases, Ninth Revision, Clinical Modification/International Classification of Diseases, Tenth Revision (ICD-9-CM/ICD-10) codes. Children with encephalopathy were defined as cases; the remainder served as controls. Thirteen (7.2%) of 181 children presented with encephalopathy (typical febrile seizures, 4; atypical febrile seizures, 4; afebrile seizures, 3; with alteration in level of consciousness alone, 2). Between cases and controls, the mean age (17.4 vs. 14.9 months, respectively) and temperature (38.4 degrees C vs. 38.5 degrees C, respectively) were not significantly different (mean age, P = 0.52; temperature, P = 0.61). The mean length of hospital stay was longer in children with encephalopathy (7 vs. 4.3 days; P = 0.03). All children recovered without sequelae. Encephalopathy, including afebrile seizures and nonconvulsive encephalopathy, is a relatively common presenting sign of acute viral gastrointestinal tract infection in hospitalized children, has a good outcome, but is associated with increased diagnostic testing and length of stay.