Kurihara Mana, Kohagizawa Toshitaka, Yoshihashi Manabu, Iino Chieko, Anzai Rie, Ida Hiroyuki
Department of Pediatrics, Kanagawa Rehabilitation Center, Atsugi, Kanagawa.
No To Hattatsu. 2011 Jul;43(4):285-90.
We investigated the prognoses of 103 children with acute encephalopathy at more than one year from the onset. The patients were divided into five groups according to the clinical courses during the acute stage;group 1:1 case with metabolic disorder, group, 2:24 with cytokine storms, group, 3:68 with prolonged convulsion more than 30 minutes, group, 4:5 with severe refractory status epilepticus, and group, 5:5 with the main symptom of impaired consciousness. We checked the past histories, etiologies, severities of consciousness loss, complications and disabilities including higher cortical dysfunction in their medical charts. The average age of onset in all cases was 3 years, with the highest age of 6 years 5 months in group 4. Regarding the past histories, febrile seizures, asthma and theophylline medication were prominent though they were not significantly different. Regarding etiologies, influenza infection, 36 cases, and HHV-6 infection, 7 cases, were prominent though they were not significantly different. Complicating disabilities comprised mental retardation, 89.3%, higher cortical dysfunction, 77.7%, epilepsies, 68.9%, and motor disturbance, 27.2%. The severity of disabilities increased in the order of 1, 2, 3, 4, 5. Attention deficit and visiospacial disturbance were the main symptoms of higher cortical dysfunction.
我们对103例急性脑病患儿起病一年多后的预后情况进行了调查。根据急性期的临床病程，将患者分为五组：第1组：1例代谢紊乱；第2组：24例细胞因子风暴；第3组：68例惊厥持续超过30分钟；第4组：5例严重难治性癫痫持续状态；第5组：5例以意识障碍为主要症状。我们查阅了他们病历中的既往史、病因、意识丧失的严重程度、并发症及残疾情况，包括高级皮质功能障碍。所有病例的平均起病年龄为3岁，第4组最高年龄为6岁5个月。关于既往史，热性惊厥、哮喘及茶碱用药较为突出，尽管差异无统计学意义。关于病因，流感感染36例，HHV - 6感染7例较为突出，尽管差异无统计学意义。并发残疾包括智力发育迟缓89.3%、高级皮质功能障碍77.7%、癫痫68.9%和运动障碍27.2%。残疾严重程度按1、2、3、4、5组依次增加。注意力缺陷和视觉空间障碍是高级皮质功能障碍的主要症状。
