Benign infantile seizures with mild gastroenteritis, first described from Japan in 1982 [1], have been commonly reported from Asia [1-3]. More recently, many cases are also being reported from non-Asian countries, albeit infrequently [4,5]. Typically, previously healthy infants aged 6 months to 3 years, present with generalized, afebrile, isolated or cluster seizures. The laboratory examination, including blood glucose, serum electrolytes, and CSF, as well as the interictal EEG and neuroimaging are normal [4,5]. Subsequent recovery from the episode is complete [4].

An 11-month-old girl presented with a 15-minute generalized tonic seizure, associated with mild gastro-enteritis of 2 days duration. There was no dehydration, and seizures subsided without any anti-convulsant treatment. Her serum glucose, electrolytes and ionic calcium, and hemogram were within normal range. The stool microscopy did not show pus cells, and bacterial culture did not reveal any organisms. Studies for Rotavirus were not done. Interictal EEG and MRI were non-contributory. Development quotient done after three months (using DASII) was 84. There was no recurrence of seizures, or developmental delay on follow-up over next 13 months. The final diagnosis made was Benign infantile seizures with mild gastroenteritis.

This syndrome – recognized only in the last decade – is still not accepted by the International League Against Epilepsy [6]. Rotavirus has been reported as the most common etiological agent in this condition in different studies [4,5]. However, other organisms have also been reported [3], and it has not been possible to attribute the convulsions to any organism, as yet [2]. The clinical symptoms are reported to precede the convulsions by an average of 2 days [4], similar to that in our case.

The importance of recognition of this condition is that it helps in avoiding unnecessary long term anti-epileptic therapy, and favorably counsel the parents about the low risk of recurrence of seizures.

1. Uemura N, Okumara A, Negoro T, 　Watanabe K. Clinical features of benign convulsions with mild gastroenteritis. Brain Dev. 2002;24:745-9.

2. Narchi H. Benign afebrile cluster convulsions with gastroenteritis: an observational study. BMC Pediatr. 2004;4:2.

3. Abe T, Kobayashi M, Arki K, 　Kodama H,　Fujita Y,　Shinozaki T, et al. Infantile convulsions with mild gastroenteritis. Brain Dev. 2000;22:1367-70.

4. Youssef WF, Ramírez RP, Plana JC, Marfa MP. Benign afebrile convulsions in the course of mild acute gastroenteritis: a study of 28 patients and a literature review. Pediatr Emerg Care. 2011;27:1062-4.

5. Caraballo RH, Gañez L, Santos Cde L, Espeche A, Cersósimo R, Fejerman N. Benign infantile seizures with mild gastroenteritis: study of 22 patients. Seizure. 2009;18:686-9.