The risk of subsequent febrile or nonfebrile seizures following Shigella-associated convulsions was investigated in 55 children in a ten year follow-up study at the Assaf Harofeh Medical Center and the Sackler School of Medicine, Tel Aviv University, Israel. Only two children (3%) had recurrent episodes of febrile convulsions and none had nonfebrile seizures. The incidence of recurrent seizures in this group of patients was similar to that observed in the general population and significantly different from the average estimated recurrence rate of febrile seizures (33%). [1]
COMMENT. Among 1292 patients with convulsions associated with Shigellosis in nine publications in the literature, the incidence of seizures varied from 4% to as high as 45% with an average of 13%. Among 2241 patients in two studies of Shigella negative diarrheas the incidence of convulsions was only 1.7%. The higher incidence of febrile seizures with shigellosis in comparison with Shigella negative diarrheas was unexplained by neurotoxin formation and could be related to differences in severity of the infections, the height of the fever, and complications of water and electrolyte imbalance. (Millichap JG. Febrile convulsions. Macmillan Company, New York, 1968). The present study suggests that Shigella-associated convulsions are benign and not associated with an increased incidence of either febrile or nonfebrile seizures. An hereditary factor to explain an increased incidence of convulsions with Shigella infections was not supported by this study.