Rotavirus 장염에서의 신경학적 이상에 관한 연구 = A Clinical Study of Neurologic Abnormalities Associated with Rotavirus Gastroenteritis

다국어 초록 (Multilingual Abstract)

Purpose:Reports of neurologic abnormalities associated with acute diarrhea are increasing recently. It was reported that the incidence of the neurologic abnormalities related to gastroenteritis was higher in rotavirus gastroenteritis than in non-rotavirus gastroenteritis. We investigated the incidence, the manifestations and the prognosis of the neurologic abnormalities associated with rotavirus diarrhea and non-rotavirus diarrhea in Korean children.
Methods:Six hundred forty-nine children who showed acute diarrhea and whose stools were examined for rotavirus were enrolled and categorized into the rotavirus positive group(n=186) and the negative group(n=463). The medical records were reviewed retrospectively for neurologic manifestations, diagnoses and the status of follow-up.
Results:The incidence of neurologic abnormalities in all children with diarrhea was 9.4%. Neurologic abnormalities associated with diarrhea were more common in the rotavirus positive group than in the rotavirus negative group(16.1% vs 6.7%, P=0.0002). The neurologic diagnoses of the children ranged from simple febrile convulsion to encephalitis. The rate of patients presenting neurologic abnormalities other than seizures was relatively higher in the rotavirus positive group than in the rotavirus negative group(56.7% vs 25.8%, P=0.01). All children with neurologic abnormalities showed complete recovery.
Conclusion:The incidence of neurologic abnormalities among patients with diarrhea was about 9%. The neurologic diagnoses in patients who showed neurologic abnormalities were diversed. In rotavirus gastroenterits, the rate of patients presenting neurologic abnormalities other than seizure was higher than in non-rotavirus gastroenteritis. The outcome of the children who showed neurologic abnormalities with diarrhea was excellent.

국문 초록 (Abstract)

목 적 : 최근 설사와 동반되어 신경학적 이상을 보이는 사례들의 보고가 증가되고 있다. 특히 rotavirus에 의한 급성 위장관염과 동반되어 신경학적 이상을 나타내는 빈도가 높다는 연구들이 보고되고 있고, 실제로 뇌척수액에서 그 검체를 규명하기도 하였다. 그러나 아직 연구가 충분하지 못하기에 경험한 사례들을 통해 rotavirus 및 non-rotavirus 설사와 연관된 신경학적 이상의 빈도와 임상 양상 및 예후에 관하여 조사하였다.방 법 : 2001년 3월부터 2002년 8월까지 한양대학교 소아과에 내원하여, 설사 증상으로 대변 rotavirus 검사를 받은 649명(평균 연령 : 13개월, 남 : 여 365명 : 284명)을 대상으로 하였다. 전체 설사 환아에서 신경학적 이상을 나타낸 빈도를 구하고, 대변 rotavirus 검사상 양성인 군(186명, 평균 연령 : 12개월, 남 : 여 113명 : 73명)과 음성인 군(463명, 평균 연령 : 14개월, 남 : 여 252명 : 211명)으로 나누어 각 군에서 신경학적 이상을 나타낸 환아의 비율을 통계적으로 비교하였다. 임상 양상은 의무 기록을 통해 후향적으로 조사하였고, 두 군간의 임상적 진단의 차이도 비교 조사하였다,

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