Scientific Letter
Review of para-infectious seizures from January 2012 to March 2014
Revisión crisis parainfecciosas de enero del 2012 a marzo del 2014
E. Hernández Frutos
, D. Conejo Moreno, I. Arribas Montero, M. Hortigüela Saeta, M.L. Angulo García
Corresponding author
Servicio de Pediatría, Hospital Universitario de Burgos, Burgos, Spain
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"apellidos" => "Hernández Frutos" "email" => array:1 [ 0 => "estherhdezfrutos@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "D." "apellidos" => "Conejo Moreno" ] 2 => array:2 [ "nombre" => "I." "apellidos" => "Arribas Montero" ] 3 => array:2 [ "nombre" => "M." "apellidos" => "Hortigüela Saeta" ] 4 => array:2 [ "nombre" => "M.L." "apellidos" => "Angulo García" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Pediatría, Hospital Universitario de Burgos, Burgos, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Revisión crisis parainfecciosas de enero del 2012 a marzo del 2014" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Parainfectious seizures are afebrile convulsive seizures associated with minor infectious diseases, such as upper respiratory tract infections or acute gastroenteritis without electrolyte abnormalities or dehydration,<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1–6</span></a> and are little-known in our country.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1,3,4</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">The aim of this retrospective descriptive study was to determine the incidence of parainfectious seizures in a tertiary hospital and to analyse the main characteristics of these seizures as well as their natural course. The inclusion criteria were having one or multiple afebrile seizures (body temperature equal or less than 37.9<span class="elsevierStyleHsp" style=""></span>°C) in association with a minor infection (upper respiratory tract infection or acute gastroenteritis without electrolyte abnormalities or clinical signs of dehydration); normal psychomotor development; and normal results in diagnostic tests.</p><p id="par0015" class="elsevierStylePara elsevierViewall">We excluded patients that had fever during the seizures, previously diagnosed with epilepsy, or with psychomotor retardation.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Our study (<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>) included 11 patients ranging in age from 3 months to 5 years, 7 of who were male and 4 female. Only one of them had had a typical febrile seizure in the past.</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The number of seizures ranged from a single seizure to a cluster of 10 seizures, and their duration from less than 1<span class="elsevierStyleHsp" style=""></span>min to 20<span class="elsevierStyleHsp" style=""></span>min (mean duration, 5.7<span class="elsevierStyleHsp" style=""></span>min), with 81.8% of seizures lasting less than 5<span class="elsevierStyleHsp" style=""></span>min. Generalised tonic-clonic seizures were the most frequent type (54.5%).</p><p id="par0030" class="elsevierStylePara elsevierViewall">Of the 11 patients, 5 had upper respiratory tract infections, and 6 acute gastroenteritis.</p><p id="par0035" class="elsevierStylePara elsevierViewall">Salmonella was isolated in 1 of the 5 stool cultures performed, and rotavirus in 2.</p><p id="par0040" class="elsevierStylePara elsevierViewall">An acute-phase electroencephalogram was done in 10 of the 11 patients, and was normal in 40% (3 of the remaining patients had a slow EEG, and another 3 irritative features).</p><p id="par0045" class="elsevierStylePara elsevierViewall">The neuroimaging tests performed included six magnetic resonance studies and one computer-assisted tomography, all of which were normal except in one patient that had non-obstructive non-progressive hydrocephalus.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Five patients required anticonvulsants to control their seizures in the emergency room, and were given benzodiazepines (diazepam or midazolam). Six of the patients that were hospitalised required anticonvulsants at a later point, and sodium valproate and levetiracetam were used most frequently. Only four patients required maintenance treatment at discharge, and one needed combination therapy.</p><p id="par0055" class="elsevierStylePara elsevierViewall">All patients were followed up at the hospital. Only one patient went on to develop epilepsy (partial seizures with secondary generalisation).</p><p id="par0060" class="elsevierStylePara elsevierViewall">Parainfectious or convulsive seizures associated to minor infections such as acute gastroenteritis or upper respiratory tract infections are rare in Spain.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1–6</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">To date, most of the case series conducted in Spain associate parainfectious seizures with acute gastroenteritis.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1–3,5,6</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">The case series published by Lara Helgueda et al.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a> showed that parainfectious seizures occurred in association with acute gastroenteritis in 67.6% of patients and with upper respiratory tract infections in 32.4%, figures that are very similar to those found in our series, which are 54.5% and 45.5%, respectively.</p><p id="par0075" class="elsevierStylePara elsevierViewall">It is common for multiple seizures to occur in the course of a single infection, but this is not a necessary criterion for diagnosis.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">1–6</span></a> In fact, in our study we observed that four of the patients (36.4%) had a single seizure.</p><p id="par0080" class="elsevierStylePara elsevierViewall">The imaging test performed most frequently was magnetic resonance imaging of the brain, which was ordered in 70% of cases and yielded abnormal results in only one patient (hydrocephalus). These data are consistent with what is reported in the literature.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">4</span></a></p><p id="par0085" class="elsevierStylePara elsevierViewall">Parainfectious seizures have shown a tendency to be refractory to treatment.<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">2–5</span></a> This was not observed in our series, in which 54.4% of patients required maintenance therapy for cluster seizures and only one patient required combined therapy.</p><p id="par0090" class="elsevierStylePara elsevierViewall">Of all the patients reviewed in this study that had a convulsive seizure diagnosis at admission, only 54.5% were discharged with a final diagnosis of parainfectious seizures.</p><p id="par0095" class="elsevierStylePara elsevierViewall">All patients were followed up in our office and had favourable outcomes, with no subsequent history of seizures save for one patient that developed partial epilepsy.</p><p id="par0100" class="elsevierStylePara elsevierViewall">In conclusion, parainfectious seizures occur rarely in Spain, resulting in underdiagnosis and consequently in the performance of a considerable number of diagnostic tests and the administration of unnecessary treatments.</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interest</span><p id="par0105" class="elsevierStylePara elsevierViewall">The authors declare that there is no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:2 [ 0 => array:2 [ "identificador" => "sec0005" "titulo" => "Conflict of interest" ] 1 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Hernández Frutos E, Conejo Moreno D, Arribas Montero I, Hortigüela Saeta M, Angulo García ML. Revisión crisis parainfecciosas de enero del 2012 a marzo del 2014. An Pediatr (Barc). 2015;82:195–197.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">FH, family history; AGE, acute gastroenteritis; CPR, chain polymerase reaction; N, normal; CT, computed tomography; MRI, magnetic resonance imaging; GTC, generalized tonic clonic; URTI, upper respiratory infection; LEV, levetiracetam; VPA, valproate; ER, stesolid rectal; RD, rectal diazepam.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Case \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Sex \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Age \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">FH \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">N.seizures \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Duration \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Seizure type \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Intercurrent infection \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Blood tests \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">EEG \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Neuroimaging \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">PL \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Tx \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Txat discharge \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Outcome \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Tonic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">URTI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Neutrophils<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>CRP \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">GTC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">URTI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Slow \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MRI:normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes:normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">LEV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">LEV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">GTC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AGE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MRI:normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes:normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ER: IV midazolam \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Epilepsy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">GTC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">URTI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Slow \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MRI:normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes:normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ER: RD<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>midazolamVPA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">VPA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Narcolepsy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">GTC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AGE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MRI:normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes:normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">LEV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">VPA<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>LEV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Secondarily generalised partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AGE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Irritative activity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MRI:normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes:normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">LEV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">LEV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Epilepsy \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Secondarily generalised partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">URTI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Lymphocytosis \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ER: RD<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>midazolamVPA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Febrile seizures \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">GTC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AGE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Centrotemporal irritative activity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">MRI:hydrocephalus \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Partial epilepsy \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Unknown \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Tonic \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">URTI \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ER: RD \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">10 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Male \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">GTC \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AGE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Slow \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">CT:normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Yes:normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">N \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">11 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Female \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">No \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Secondarily generalised partial \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">AGE \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Centrotemporal irritative activity \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">Normal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">ER: RDVPA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">LEV \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="" valign="top"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab752223.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Analysed cases.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:6 [ 0 => array:3 [ "identificador" => "bib0035" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Crisis convulsivas asociadas a gastroenteritis: estudio de incidencia y análisis clínico" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S. Lacasa Maseri" 1 => "J.M. Ramos Fernández" 2 => "D. Moreno Pérez" 3 => "A. Urda Cardona" 4 => "J. Martínez Antón" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Pediatr (Barc)" "fecha" => "2013" "volumen" => "79" "paginaInicial" => "162" "paginaFinal" => "166" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0040" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Convulsiones benignas durante gastroenteritis leve por rotavirus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Cancho-Candela" 1 => "A. Peña-Valenceja" 2 => "C. Alcalde Martín" 3 => "M. Ayuso Hernández" 4 => "O. Medrano Sánchez" 5 => "C. Ochoa Sangrador" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Neurol" "fecha" => "2009" "volumen" => "49" "paginaInicial" => "230" "paginaFinal" => "233" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19714552" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0045" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Asociación entre gastroenteritis aguda leve y convulsiones afebriles benignas" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "L. Regueras Santos" 1 => "C. Iglesias Blázquez" 2 => "C. Rodríguez Fernández" 3 => "L. Fernández Pérez" 4 => "A. Jiménez González" 5 => "V. Recio Pacual" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:3 [ "tituloSerie" => "Boletín de la Sociedad de Pediatría de Asturias, Cantabria y Castilla y León" "fecha" => "2010" "volumen" => "50" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0050" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Crisis parainfecciosas en el niño: estudio retrospectivo de 34 casos" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "J. Lara Herguedas" 1 => "J.J. Garcia Peñas" 2 => "M.L. Ruiz Falcó" 3 => "L.G. Gutiérrez Solana" 4 => "A. Duat Rodríguez" 5 => "M.L. Arrabal Fernández" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Rev Neurol" "fecha" => "2008" "volumen" => "46" "paginaInicial" => "321" "paginaFinal" => "325" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18368673" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0055" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Rotavirus y crisis convulsivas. Una asociación poco frecuente aunque bien definida" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "I. Martí" 1 => "G. Cilla" 2 => "M. Gomáriz" 3 => "J. Eizaguirre" 4 => "C. García Pardos" 5 => "E.G. Pérez-yarza" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Pediatr (Barc)" "fecha" => "2010" "volumen" => "73" "paginaInicial" => "70" "paginaFinal" => "73" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0060" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estado epiléptico asociado a una gastroenteritis leve por rotavirus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.A. Fernández Fernández" 1 => "M. Madruga Garrido" 2 => "B. Blanco Martínez" 3 => "M. Rufo Campos" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "An Pediatr (Barc)" "fecha" => "2008" "volumen" => "69" "paginaInicial" => "263" "paginaFinal" => "266" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/23412879/0000008200000003/v2_201504151313/S2341287915000356/v2_201504151313/en/main.assets" "Apartado" => array:4 [ "identificador" => "38181" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Scientific letters" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/23412879/0000008200000003/v2_201504151313/S2341287915000356/v2_201504151313/en/main.pdf?idApp=UINPBA00005H&text.app=https://analesdepediatria.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341287915000356?idApp=UINPBA00005H" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 8 | 11 | 19 |
| 2024 October | 42 | 34 | 76 |
| 2024 September | 50 | 23 | 73 |
| 2024 August | 48 | 60 | 108 |
| 2024 July | 49 | 29 | 78 |
| 2024 June | 38 | 23 | 61 |
| 2024 May | 39 | 27 | 66 |
| 2024 April | 38 | 42 | 80 |
| 2024 March | 33 | 22 | 55 |
| 2024 February | 33 | 25 | 58 |
| 2024 January | 30 | 24 | 54 |
| 2023 December | 16 | 13 | 29 |
| 2023 November | 36 | 27 | 63 |
| 2023 October | 30 | 15 | 45 |
| 2023 September | 24 | 24 | 48 |
| 2023 August | 18 | 14 | 32 |
| 2023 July | 24 | 35 | 59 |
| 2023 June | 27 | 25 | 52 |
| 2023 May | 33 | 18 | 51 |
| 2023 April | 27 | 10 | 37 |
| 2023 March | 41 | 26 | 67 |
| 2023 February | 17 | 19 | 36 |
| 2023 January | 17 | 25 | 42 |
| 2022 December | 39 | 25 | 64 |
| 2022 November | 33 | 30 | 63 |
| 2022 October | 48 | 46 | 94 |
| 2022 September | 51 | 27 | 78 |
| 2022 August | 60 | 59 | 119 |
| 2022 July | 56 | 47 | 103 |
| 2022 June | 73 | 34 | 107 |
| 2022 May | 62 | 32 | 94 |
| 2022 April | 73 | 40 | 113 |
| 2022 March | 85 | 45 | 130 |
| 2022 February | 47 | 34 | 81 |
| 2022 January | 72 | 37 | 109 |
| 2021 December | 34 | 45 | 79 |
| 2021 November | 44 | 45 | 89 |
| 2021 October | 43 | 63 | 106 |
| 2021 September | 28 | 48 | 76 |
| 2021 August | 31 | 44 | 75 |
| 2021 July | 23 | 33 | 56 |
| 2021 June | 32 | 35 | 67 |
| 2021 May | 26 | 27 | 53 |
| 2021 April | 49 | 95 | 144 |
| 2021 March | 34 | 19 | 53 |
| 2021 February | 25 | 13 | 38 |
| 2021 January | 30 | 23 | 53 |
| 2020 December | 35 | 15 | 50 |
| 2020 November | 28 | 11 | 39 |
| 2020 October | 19 | 19 | 38 |
| 2020 September | 12 | 9 | 21 |
| 2020 August | 17 | 10 | 27 |
| 2020 July | 23 | 22 | 45 |
| 2020 June | 30 | 16 | 46 |
| 2020 May | 29 | 28 | 57 |
| 2020 April | 28 | 9 | 37 |
| 2020 March | 27 | 21 | 48 |
| 2020 February | 32 | 23 | 55 |
| 2020 January | 25 | 13 | 38 |
| 2019 December | 40 | 12 | 52 |
| 2019 November | 12 | 14 | 26 |
| 2019 October | 19 | 13 | 32 |
| 2019 September | 20 | 8 | 28 |
| 2019 August | 27 | 20 | 47 |
| 2019 July | 30 | 17 | 47 |
| 2019 June | 27 | 20 | 47 |
| 2019 May | 68 | 45 | 113 |
| 2019 April | 55 | 37 | 92 |
| 2019 March | 31 | 22 | 53 |
| 2019 February | 27 | 21 | 48 |
| 2019 January | 31 | 16 | 47 |
| 2018 December | 37 | 29 | 66 |
| 2018 November | 52 | 18 | 70 |
| 2018 October | 50 | 19 | 69 |
| 2018 September | 39 | 14 | 53 |
| 2018 August | 2 | 0 | 2 |
| 2018 July | 3 | 0 | 3 |
| 2018 June | 3 | 0 | 3 |
| 2018 May | 3 | 0 | 3 |
| 2018 April | 18 | 0 | 18 |
| 2018 March | 36 | 0 | 36 |
| 2018 February | 9 | 0 | 9 |
| 2018 January | 8 | 0 | 8 |
| 2017 December | 8 | 0 | 8 |
| 2017 November | 16 | 0 | 16 |
| 2017 October | 10 | 0 | 10 |
| 2017 September | 16 | 0 | 16 |
| 2017 August | 14 | 0 | 14 |
| 2017 July | 17 | 2 | 19 |
| 2017 June | 31 | 10 | 41 |
| 2017 May | 22 | 7 | 29 |
| 2017 April | 23 | 6 | 29 |
| 2017 March | 9 | 1 | 10 |
| 2017 February | 16 | 6 | 22 |
| 2017 January | 11 | 2 | 13 |
| 2016 December | 47 | 6 | 53 |
| 2016 November | 49 | 7 | 56 |
| 2016 October | 54 | 8 | 62 |
| 2016 September | 40 | 8 | 48 |
| 2016 August | 28 | 3 | 31 |
| 2016 July | 14 | 5 | 19 |
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