Kato T, Okumura A, Hayakawa F, Tsuji T, Natsume J, Watanabe K
Department of Pediatrics, Okazaki City Hospital, Okazaki, Japan.
Neuropediatrics. 2011 Oct;42(5):183-7. doi: 10.1055/s-0031-1295411. Epub 2011 Nov 22.
We have studied the clinical and neuroimaging characteristics of transient and mild reduction of consciousness during febrile illness in children. We retrospectively evaluated 58 children admitted with mild reduction of consciousness within 12 h during febrile illness. 53 patients (91%) had delirious behavior, and 5 (9%) had no delirious behavior. We also compared the clinical characteristics, brain magnetic resonance imaging (MRI) findings, and electroencephalography (EEG) findings between patients with and without delirious behavior, and no statistically significant differences were observed in any of them between the 2 patient groups (P≥0.05). MRI was performed 0-4 days after onset in 23 patients. Reversible splenial or callosal and white matter lesions were observed in 2 of 3 patients without delirious behavior vs. 4 of 20 patients with delirious behavior on diffusion-weighted images. EEG was performed 0-3 days after onset in 29 patients. Transient abnormal findings were observed in 3 of 4 patients without delirious behavior vs. 11 of 25 patients with delirious behavior. In conclusion, we consider that transient and mild reduction of consciousness during febrile illness is a unique clinical group that is constituted by children both with and without delirious behavior.
我们研究了儿童发热性疾病期间意识短暂轻度减退的临床和神经影像学特征。我们回顾性评估了58例在发热性疾病期间12小时内出现意识轻度减退而入院的儿童。53例患者（91%）有谵妄行为，5例（9%）无谵妄行为。我们还比较了有谵妄行为和无谵妄行为患者之间的临床特征、脑磁共振成像（MRI）结果和脑电图（EEG）结果，两组患者在任何一项指标上均未观察到统计学显著差异（P≥0.05）。23例患者在发病后0 - 4天进行了MRI检查。在扩散加权图像上，3例无谵妄行为的患者中有2例、20例有谵妄行为的患者中有4例观察到可逆的胼胝体或胼胝体及白质病变。29例患者在发病后0 - 3天进行了脑电图检查。4例无谵妄行为的患者中有3例、25例有谵妄行为的患者中有11例观察到短暂异常表现。总之，我们认为发热性疾病期间意识短暂轻度减退是一个独特的临床群体，由有谵妄行为和无谵妄行为的儿童共同构成。
