NEUROLOGIC MANIFESTATIONS OF A CUTE GA STROENTERITIS: A REVIEW OF 45 PATIENTS IN THE INTENSIVE CARE SETTING

Acute gastroenteritis (AGE) is a serious disease and is one of the most important causes of early childhood mortality in developing countries. The neurologic manifestations can be propounded as primary symptoms of AGE. In order to determine the rate, clinical presentations, and outcome of patients with AGE who presented with neurologic manifestations and compare them with patients without neurologic symptoms, we reviewed the records of children 1 month to 14 years of age having AGE along with neurologic presentations, i.e. either convulsion or encephalopathy alone or together who had been admitted to the pediatric intensive care unit (PICU) of the Children's Hospital Medical Center (CHMS) from September 1996 till August 1998. Among all the patients admitted at that time, 7% (75 patients) had AGE, of which 60% (45 patients) had concomitant neurologic symptoms including 4% who had convulsion alone, 20% had encephalopathy alone, and 36% showed both of the symptoms. Of the patients who had AGE with neurologic symptoms, 36% initially presented with neurological manifestations without gastrointestinal symptoms. The duration of admission at PICU and the mortality rate among patients with AGE were significantly more in the patients with neurologic symptoms in comparison to those without neurologic symptoms. According to our findings, neurologic symptoms may be the first manifestation of AGE and are likely to increase the risk of mortality in AGE.