Involuntary movements and coma as the prognostic marker for acute encephalopathy with biphasic seizures and late reduced diffusion

Sooyoung Lee, Masafumi Sanefuji, Michiko Torio, Noriyuki Kaku, Yuko Shono, Soichi Mizuguchi, Haruhisa Baba, Yasunari Sakai, Yoshito Ishizaki, Hiroyuki Torisu, Ryutaro Kira, Toshiro Hara, Shoichi Ohga

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) occurs in children associated with infection. It is characterized by a prolonged febrile seizure in the first phase, and a cluster of seizures, deterioration of consciousness and the white matter lesions with reduced diffusion in the second phase. The patients often have severe neurological sequelae, but the prognostic indicators remain unknown. The present study aimed to clarify the characteristics of AESD patients who subsequently exhibited severe neurological sequelae. We retrospectively analyzed the clinical and laboratory findings along with the brain imaging in patients who had severe (n = 8) and non-severe neurodevelopmental outcomes (n = 12). Severe group more frequently showed coma (p = 0.014) or involuntary movements including dystonia and oral dyskinesia (p = 0.018) before the second phase than non-severe group. Severe group exhibited higher levels of serum alanine aminotransferase than non-severe group (p = 0.001). Quantitatively assessed MRI in the second phase revealed that severe group had more extensive lesions than non-severe group, in the anterior (p = 0.015) and posterior parts (p = 0.011) of the cerebrum and basal ganglia (p = 0.020). Early appearing involuntary movements or coma might account for the extension of acute brain lesions and the poor neurological outcomes in AESD patients.

Original languageEnglish
Pages (from-to)39-43
Number of pages5
JournalJournal of the Neurological Sciences
Volume370
DOIs
Publication statusPublished - Nov 15 2016

Fingerprint

Dyskinesias
Brain Diseases
Coma
Seizures
Febrile Seizures
Dystonia
Movement Disorders
Cerebrum
Basal Ganglia
Consciousness
Alanine Transaminase
Neuroimaging
Brain
Infection
Serum

All Science Journal Classification (ASJC) codes

  • Neurology
  • Clinical Neurology

Cite this

Involuntary movements and coma as the prognostic marker for acute encephalopathy with biphasic seizures and late reduced diffusion. / Lee, Sooyoung; Sanefuji, Masafumi; Torio, Michiko; Kaku, Noriyuki; Shono, Yuko; Mizuguchi, Soichi; Baba, Haruhisa; Sakai, Yasunari; Ishizaki, Yoshito; Torisu, Hiroyuki; Kira, Ryutaro; Hara, Toshiro; Ohga, Shoichi.

In: Journal of the Neurological Sciences, Vol. 370, 15.11.2016, p. 39-43.

Research output: Contribution to journalArticle

Lee, Sooyoung ; Sanefuji, Masafumi ; Torio, Michiko ; Kaku, Noriyuki ; Shono, Yuko ; Mizuguchi, Soichi ; Baba, Haruhisa ; Sakai, Yasunari ; Ishizaki, Yoshito ; Torisu, Hiroyuki ; Kira, Ryutaro ; Hara, Toshiro ; Ohga, Shoichi. / Involuntary movements and coma as the prognostic marker for acute encephalopathy with biphasic seizures and late reduced diffusion. In: Journal of the Neurological Sciences. 2016 ; Vol. 370. pp. 39-43.
@article{ef74037b6b8b4565bf31080659baf301,
title = "Involuntary movements and coma as the prognostic marker for acute encephalopathy with biphasic seizures and late reduced diffusion",
abstract = "Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) occurs in children associated with infection. It is characterized by a prolonged febrile seizure in the first phase, and a cluster of seizures, deterioration of consciousness and the white matter lesions with reduced diffusion in the second phase. The patients often have severe neurological sequelae, but the prognostic indicators remain unknown. The present study aimed to clarify the characteristics of AESD patients who subsequently exhibited severe neurological sequelae. We retrospectively analyzed the clinical and laboratory findings along with the brain imaging in patients who had severe (n = 8) and non-severe neurodevelopmental outcomes (n = 12). Severe group more frequently showed coma (p = 0.014) or involuntary movements including dystonia and oral dyskinesia (p = 0.018) before the second phase than non-severe group. Severe group exhibited higher levels of serum alanine aminotransferase than non-severe group (p = 0.001). Quantitatively assessed MRI in the second phase revealed that severe group had more extensive lesions than non-severe group, in the anterior (p = 0.015) and posterior parts (p = 0.011) of the cerebrum and basal ganglia (p = 0.020). Early appearing involuntary movements or coma might account for the extension of acute brain lesions and the poor neurological outcomes in AESD patients.",
author = "Sooyoung Lee and Masafumi Sanefuji and Michiko Torio and Noriyuki Kaku and Yuko Shono and Soichi Mizuguchi and Haruhisa Baba and Yasunari Sakai and Yoshito Ishizaki and Hiroyuki Torisu and Ryutaro Kira and Toshiro Hara and Shoichi Ohga",
year = "2016",
month = "11",
day = "15",
doi = "10.1016/j.jns.2016.09.018",
language = "English",
volume = "370",
pages = "39--43",
journal = "Journal of the Neurological Sciences",
issn = "0022-510X",
publisher = "Elsevier",

}

TY - JOUR

T1 - Involuntary movements and coma as the prognostic marker for acute encephalopathy with biphasic seizures and late reduced diffusion

AU - Lee, Sooyoung

AU - Sanefuji, Masafumi

AU - Torio, Michiko

AU - Kaku, Noriyuki

AU - Shono, Yuko

AU - Mizuguchi, Soichi

AU - Baba, Haruhisa

AU - Sakai, Yasunari

AU - Ishizaki, Yoshito

AU - Torisu, Hiroyuki

AU - Kira, Ryutaro

AU - Hara, Toshiro

AU - Ohga, Shoichi

PY - 2016/11/15

Y1 - 2016/11/15

N2 - Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) occurs in children associated with infection. It is characterized by a prolonged febrile seizure in the first phase, and a cluster of seizures, deterioration of consciousness and the white matter lesions with reduced diffusion in the second phase. The patients often have severe neurological sequelae, but the prognostic indicators remain unknown. The present study aimed to clarify the characteristics of AESD patients who subsequently exhibited severe neurological sequelae. We retrospectively analyzed the clinical and laboratory findings along with the brain imaging in patients who had severe (n = 8) and non-severe neurodevelopmental outcomes (n = 12). Severe group more frequently showed coma (p = 0.014) or involuntary movements including dystonia and oral dyskinesia (p = 0.018) before the second phase than non-severe group. Severe group exhibited higher levels of serum alanine aminotransferase than non-severe group (p = 0.001). Quantitatively assessed MRI in the second phase revealed that severe group had more extensive lesions than non-severe group, in the anterior (p = 0.015) and posterior parts (p = 0.011) of the cerebrum and basal ganglia (p = 0.020). Early appearing involuntary movements or coma might account for the extension of acute brain lesions and the poor neurological outcomes in AESD patients.

AB - Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) occurs in children associated with infection. It is characterized by a prolonged febrile seizure in the first phase, and a cluster of seizures, deterioration of consciousness and the white matter lesions with reduced diffusion in the second phase. The patients often have severe neurological sequelae, but the prognostic indicators remain unknown. The present study aimed to clarify the characteristics of AESD patients who subsequently exhibited severe neurological sequelae. We retrospectively analyzed the clinical and laboratory findings along with the brain imaging in patients who had severe (n = 8) and non-severe neurodevelopmental outcomes (n = 12). Severe group more frequently showed coma (p = 0.014) or involuntary movements including dystonia and oral dyskinesia (p = 0.018) before the second phase than non-severe group. Severe group exhibited higher levels of serum alanine aminotransferase than non-severe group (p = 0.001). Quantitatively assessed MRI in the second phase revealed that severe group had more extensive lesions than non-severe group, in the anterior (p = 0.015) and posterior parts (p = 0.011) of the cerebrum and basal ganglia (p = 0.020). Early appearing involuntary movements or coma might account for the extension of acute brain lesions and the poor neurological outcomes in AESD patients.

UR - http://www.scopus.com/inward/record.url?scp=84988039607&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84988039607&partnerID=8YFLogxK

U2 - 10.1016/j.jns.2016.09.018

DO - 10.1016/j.jns.2016.09.018

M3 - Article

VL - 370

SP - 39

EP - 43

JO - Journal of the Neurological Sciences

JF - Journal of the Neurological Sciences

SN - 0022-510X

ER -