Effect of vitamin administration on the prevention of acute encephalopathy with biphasic seizures and late reduced diffusion.

IF 1.3 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development Pub Date : 2025-08-09 DOI:10.1016/j.braindev.2025.104415

Tatsuya Takahashi, Yuichi Abe, Itaru Hayakawa, Saeko Irie, Nobuaki Tsuiki, Atsushi Nishioka, Hiroto Ida, Tsuyoshi Aihara, Kentaro Ide

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引用次数: 0

Abstract

Objective: This study examined whether encephalopathy vitamin therapy (EVT) with vitamins B1, B6, and carnitine, administered following febrile status epilepticus (FSE), could prevent acute encephalopathy with biphasic seizures and late reduced diffusion (AESD), improve neurological outcomes, and reduce pediatric intensive care unit (PICU) length of stay.

Methods: We conducted a single-center retrospective cohort study comparing patients hospitalized with suspected post-FSE acute encephalopathy and treated with EVT (2016-2022) with a historical control group of patients who did not receive EVT (2009-2010). The primary endpoint was the incidence of AESD, and the secondary endpoints were a ≥2-point worsening in the Pediatric Cerebral Performance Category (PCPC) score at PICU discharge and a decrease in PICU length of stay.

Results: The AESD incidence did not differ significantly between 43 EVT cases and 14 controls (47 % vs. 57 %, p = 0.55), even with early EVT cases starting within 24 h of the inaugural seizure (43 % vs. 57 %, p = 0.53). EVT was associated with a lower rate of ≥2-point worsening in the PCPC score (23 % vs. 57 %, p = 0.025). Moreover, EVT was associated with significantly shorter PICU length of stay (median 7.0 vs. 13.5 days; p = 0.0012).

Conclusion: EVT may mitigate acute neurological deterioration and shorten PICU length of stay; however, it has limited preventive efficacy against AESD, especially in severe cases.

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维生素给药对急性脑病双相发作和晚期弥散减少的预防作用。

目的：本研究探讨在发热性癫痫持续状态（FSE）后给予含维生素B1、B6和肉碱的脑病维生素治疗（EVT）是否可以预防急性脑病伴双相发作和晚期弥散减少（AESD），改善神经预后，并缩短儿科重症监护病房（PICU）的住院时间。方法：我们进行了一项单中心回顾性队列研究，将疑似fse后急性脑病住院并接受EVT治疗的患者（2016-2022年）与未接受EVT治疗的历史对照组（2009-2010年）进行比较。主要终点是AESD的发生率，次要终点是PICU出院时儿科脑功能分类（PCPC）评分恶化≥2分和PICU住院时间缩短。结果：43例EVT患者与14例对照组的AESD发生率无显著差异（47%对57%，p = 0.55），即使早期EVT患者在首次癫痫发作后24小时内发病（43%对57%，p = 0.53）。EVT与PCPC评分≥2点恶化率较低相关（23%对57%，p = 0.025）。此外，EVT与PICU住院时间显著缩短相关(中位7.0 vs. 13.5天；p = 0.0012)。结论：EVT可减轻急性神经功能恶化，缩短PICU住院时间；然而，它对AESD的预防效果有限，特别是在严重的病例中。

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 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.