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Long-term relapse rate in children with convulsions and mild gastroenteritis is 9.8% (95% CI 5.2%-17.7%)Children with Convulsions during Gastroenteritis May Face Relapse Risks

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Key Takeaway
Note that while acute seizure clustering is common in CwG, long-term relapse occurs in approximately 9.8% of cases.

This meta-analysis synthesized data from 3,302 children with convulsions and mild gastroenteritis (CwG) to evaluate long-term relapse rates and associated clinical factors. The primary outcome showed a long-term relapse rate of 9.8% (95% CI 5.2%-17.7%). A sensitivity analysis reported a lower relapse rate of 6.1% (95% CI 4.9%-7.5%).

Secondary findings indicated that acute multiple seizures occurred in 57.2% of cases (95% CI 47.0%-66.9%). Children with multiple seizures were, on average, 3.41 months younger than those with single seizures (95% CI -6.06 to -0.75) and had lower serum sodium levels by 1.30 mmol/L (95% CI -2.42 to -0.17). Exploratory analyses suggested higher odds for long-term recurrence in children under 18 months of age (OR 3.99; 95% CI 1.78-8.91) and those with a family history of convulsions (OR 4.74; 95% CI 2.23-10.06).

The authors noted that the evidence for age and family history as predictors is of very low certainty due to crude, unadjusted estimates from only two studies. These findings are currently considered hypothesis-generating rather than validated predictors. Clinically, while long-term relapse is uncommon, it is not negligible; acute clustering remains common during the index illness.

This meta-analysis looked at 3,302 children who experienced convulsions during an episode of mild gastroenteritis. The study aimed to understand the risk of these children having seizures again in the future and identify what factors might make them more likely to have a relapse.

The findings show that the long-term relapse rate for these children is relatively low, at about 9.8 percent. However, the researchers found that acute seizure clustering is common during the initial illness. They also noted that children who experienced multiple seizures were often younger and had lower serum sodium levels than those with a single seizure.

Some factors like being under 18 months old or having a family history of convulsions were linked to higher risks of relapse in exploratory parts of the study. However, because these specific findings came from only two studies, the evidence for them is not very strong. These results are currently used to generate ideas rather than as confirmed predictors. Talk to a doctor to understand how these factors apply to a specific child.

What this means for you:
Long-term relapse after seizures during gastroenteritis is uncommon but can be linked to age and family history.

Common questions

How common is a relapse for children who have seizures during stomach issues?

The study found that the long-term relapse rate for children with convulsions and mild gastroenteritis is about 9.8 percent. While this means most children do not have a relapse, it shows that some cases can occur after the initial illness.

Are there specific factors that increase the risk of a relapse?

The study looked at age and family history as potential risks. Children under 18 months old and those with a family history of convulsions showed higher odds of recurrence, but these findings are based on limited data and have low certainty.

What did the study find about multiple seizures during the first illness?

Acute seizure clustering was common, occurring in 57.2 percent of cases. Children with multiple seizures were found to be an average of 3.41 months younger and had lower serum sodium levels than those who only had one seizure.

Study Details

Study typeMeta analysis
Sample sizen = 3,302
EvidenceLevel 1
Follow-up18.0 mo
PublishedJul 2026
View Original Abstract ↓
UNLABELLED: To evaluate acute and long-term recurrence in children with convulsions with mild gastroenteritis (CwG) and to identify candidate factors associated with long-term relapse. This PRISMA 2020-compliant systematic review and meta-analysis (PROSPERO CRD420261348817) searched five databases from inception to March 25, 2026. Observational studies of children with CwG reporting recurrence-related outcomes were included. Random-effects models were used for all pooled analyses. Twenty-one studies (3,302 participants) were included. The primary pooled long-term relapse rate was 9.8% (95% CI 5.2%-17.7%; I2 = 88.5%); a sensitivity analysis excluding two studies with broader recurrence definitions yielded 6.1% (95% CI 4.9%-7.5%; I2 = 0.0%). Age below 18 months (OR 3.99, 95% CI 1.78-8.91; I2 = 0.0%) and family history of convulsions (OR 4.74, 95% CI 2.23-10.06; I2 = 0.0%) were each associated with long-term recurrence in exploratory pooled analyses of crude odds ratios from two studies. Acute multiple seizures occurred in 57.2% of children (95% CI 47.0%-66.9%; I2 = 86.5%); children with multiple seizures were younger (mean difference - 3.41 months, 95% CI - 6.06 to - 0.75) and had lower serum sodium (- 1.30 mmol/L, 95% CI - 2.42 to - 0.17) than those with a single seizure. CONCLUSION: Long-term relapse occurred in approximately 6%-10% of children with CwG, depending on the recurrence definition (9.8% primary estimate; 6.1% sensitivity estimate). Age below 18 months and family history were each associated with relapse in exploratory two-study analyses; given crude, unadjusted estimates and very low certainty, these should be regarded as hypothesis-generating candidate factors rather than validated predictors. WHAT IS KNOWN: • CwG generally has a favourable neurological prognosis, but recurrence remains a concern for clinicians and families. • Acute seizure clustering and later relapse are distinct outcomes, yet previous studies often analysed them together. WHAT IS NEW: • Long-term relapse was uncommon but not negligible, whereas acute clustering was common during the index illness. • Younger age, family history, and lower serum sodium were hypothesis-generating candidate factors requiring prospective validation.
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