Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8275186 | Journal of the Neurological Sciences | 2015 | 4 Pages |
Abstract
Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) at onset manifests an early seizure (ES) usually lasting more than 30 min. Following ES, some patients exhibit almost clear consciousness with no neurological symptoms, and no MRI abnormality for a few days, which may lead to an initial misdiagnosis of prolonged febrile seizures (PFS). To allow an early diagnosis of AESD, we retrospectively analyzed clinical manifestations, laboratory data, and radiologic and EEG findings in patients with AESD (n = 62) having ES of over 30 min, and ones with PFS (n = 54), using logistic regression analyses. Multivariate logistic regression analysis revealed that an age below 1.5 years and a Glasgow Coma Scale score of 14 or less than 14 (Japan Coma Scale score of 1 or higher) were high risk factors of developing AESD. We proposed an AESD prediction score system consisting of consciousness level, age, duration of convulsions, enforcement of mechanical intubation, and aspartate aminotransferase, blood glucose and creatinine levels (full score: 9), the mean scores in AESD and PFS being 5.9 and 1.8, which were significantly different (p < 0.001). We herein propose a scoring system for differentiating patients with AESD and PFS around the time of ES (score of 4 or more than 4 suggesting AESD), which may contribute to early therapeutic intervention and an improved neurologic outcome.
Keywords
ANEHSEsJCSAESDAcute encephalopathy with biphasic seizures and late reduced diffusion (AESD)GCsMMPDWIALTPFsASTAspartate aminotransferaseAlanine aminotransferaseAcute encephalopathy with biphasic seizures and late reduced diffusionacute necrotizing encephalopathyPediatricinterleukinBtALogistic regression analysisEarly seizureTIMPInfectionBlood sugarlactate dehydrogenaseLDHmatrix metalloproteinaseCerebrospinal fluidCSFGlasgow coma scaleTissue inhibitor of metalloproteinase 1Predictive scorecreatinine
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Authors
Hiroko Tada, Jun-ichi Takanashi, Hideo Okuno, Masaya Kubota, Takanori Yamagata, Gou Kawano, Takashi Shiihara, Shin-ichiro Hamano, Shinichi Hirose, Takuya Hayashi, Hitoshi Osaka, Masashi Mizuguchi,