Underlying seizure susceptibility in children with infection-related acute encephalopathy
Abstract number :
3.165
Submission category :
4. Clinical Epilepsy / 4C. Clinical Treatments
Year :
2016
Submission ID :
196144
Source :
www.aesnet.org
Presentation date :
12/5/2016 12:00:00 AM
Published date :
Nov 21, 2016, 18:00 PM
Authors :
Tomohiko Nakata, Nagoya University, Nagoya, Japan; Hiroyuki Kidokoro, Nagoya University Graduate School of Medicine; Atsuko Ohno, Nagoya University; Hiroyuki Yamamoto, Nagoya University Graduate School of Medicine; Yuji Ito, Nagoya University Graduate Sch
Rationale: Children with infection-related acute encephalopathy/encephalitis (AE) show neurological symptoms such as impairment of consciousness and seizures. Some of these patients have underlying disorders such as Dravet syndrome, and it is suggested that underlying seizure susceptibility may be a predisposing factor which leads to the onset of AE. To clarify the intrinsic factors to induce AE, we investigated the underlying disorders and past medical illness of the patients with AE. Methods: We enrolled patients with AE between April 2009 and March 2015 from the database of the Tokai Pediatric Neurology Society that consists of four universities and affiliated hospitals in Japan. We extracted patients with three types of AE based on clinico-radiological findings: acute disseminated encephalomyelitis (ADEM), acute encephalopathy with biphasic seizures and late reduced diffusion (AESD), and mild encephalopathy with reversible splenial lesion (MERS). Underlying disorders and past histories of medical illness were retrospectively examined. Results: We studied 39 patients with ADEM, 120 with AESD, and 75 with MERS. Underlying disorders or past medical illness were detected in 4 of 39 patients with ADEM (10%), 42 of 120 with AESD (35%), and 19 of 75 with MERS (25%). Prevalence of underlying disease or past medical illness was significantly higher in patients with AESD than that in patients with ADEM or MERS (Chi-square test, p < 0.05). In patients with AESD, 18 patients had seizure disorders and 15 patients were born prematurely. The seizure disorders in patients with AESD were Dravet syndrome in 2 patients, West syndrome in 3, other epilepsy in 8, febrile seizure in 3, and single afebrile seizure in 2. Seven patients had histories of status epilepticus. In patients with MERS, 2 patients had epilepsy, 2 had repeated febrile seizures, and 1 had both. Conclusions: The present study revealed seizure predisposition in patients with AESD and MERS. These two types of infection-related AE are supposed to be induced by a combination of an intrinsic factor of seizure susceptibility and an extrinsic factor of infectious illness. Funding: none
Clinical Epilepsy