Risk factors for post-encephalopathic epilepsy in patients with acute encephalopathy with biphasic seizures and late reduced diffusion

IF 1.4 4区 医学 Q4 CLINICAL NEUROLOGY
Makoto Nishioka , Mitsuo Motobayashi , Tetsuhiro Fukuyama , Yuji Inaba
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引用次数: 0

Abstract

Background

Post-encephalopathic epilepsy (PEE) is a serious complication of acute encephalopathy syndromes, and is more frequent in patients with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) than in children with acute encephalopathy. However, a risk factor analysis using laboratory findings in the acute phase of AESD has not yet been performed. Therefore, the present study examined risk factors of AESD-related PEE using laboratory parameters in the acute phase of AESD.

Methods

We retrospectively screened 27 pediatric patients with AESD for inclusion, and enrolled 20 (“the PEE group”, n = 6; “the non-PEE group”, n = 14) according to inclusion criteria.

Results

The incidence of AESD-related PEE was 30 %, and the median duration from the onset of AESD to the development of PEE was 2.5 months (range, 1–32). The most common types of seizures were focal seizures, epileptic spasms, and startle seizures: 4 out of 6 patients (66.7 %) had intractable epilepsy. The median values of alanine aminotransferase (ALT) in the 1st and 2nd seizure phases of AESD and aspartate aminotransferase (AST) in the 2nd seizure phase were significantly higher in the PEE group than in the non-PEE group (p < 0.01).

Conclusions

This is the first study to report higher serum levels of ALT and AST at the onset of AESD as risk factors for AESD-related PEE. We also provided a detailed description on the clinical characteristics on AESD-related PEE, which are consistent with previous findings.

伴有双相癫痫发作和晚期弥散功能减退的急性脑病患者发生脑病后癫痫的风险因素
背景脑病后癫痫(PEE)是急性脑病综合征的一种严重并发症,在伴有双相癫痫发作和晚期弥散功能减退的急性脑病(AESD)患者中的发病率高于急性脑病患儿。然而,利用 AESD 急性期的实验室结果进行风险因素分析的工作尚未开展。因此,本研究利用 AESD 急性期的实验室指标对 AESD 相关 PEE 的风险因素进行了研究。方法我们回顾性筛选了 27 例 AESD 儿童患者,并根据纳入标准纳入了 20 例("PEE 组",n = 6;"非 PEE 组",n = 14)。最常见的癫痫发作类型是局灶性癫痫发作、癫痫痉挛和惊厥发作:6 名患者中有 4 名(66.7%)患有难治性癫痫。PEE 组患者在 AESD 第一和第二发作期的丙氨酸氨基转移酶 (ALT) 中位值以及在第二发作期的天冬氨酸氨基转移酶 (AST) 中位值显著高于非 PEE 组患者(p < 0.01)。我们还详细描述了 AESD 相关 PEE 的临床特征,这些特征与之前的研究结果一致。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Brain & Development
Brain & Development 医学-临床神经学
CiteScore
3.60
自引率
0.00%
发文量
153
审稿时长
50 days
期刊介绍: Brain and Development (ISSN 0387-7604) is the Official Journal of the Japanese Society of Child Neurology, and is aimed to promote clinical child neurology and developmental neuroscience. The journal is devoted to publishing Review Articles, Full Length Original Papers, Case Reports and Letters to the Editor in the field of Child Neurology and related sciences. Proceedings of meetings, and professional announcements will be published at the Editor''s discretion. Letters concerning articles published in Brain and Development and other relevant issues are also welcome.
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