Matsuda Takuya, Shimakawa Shuichi, Toshikawa Hiromitsu, Hatanaka Mari, Fukui Miho, Mori Atsushi, Tamai Hiroshi
Department of Pediatrics, Osaka Medical College, Takatsuki, Osaka, Japan.
Department of Pediatrics, Osaka Medical College, Takatsuki, Osaka, Japan.
Brain Dev. 2016 Nov;38(10):943-946. doi: 10.1016/j.braindev.2016.05.001. Epub 2016 Aug 29.
We report a 13-month-old girl who developed acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) with transient reduced diffusion in the hippocampus and anterior commissure on diffusion-weighted imaging (DWI), which was performed on the first day after febrile status epilepticus (FSE) as the initial neurological symptom of AESD. DWI just after late seizures showed high signal intensity lesions in both left hippocampus and anterior commissure, and left extratemporal and occipital subcortical white matter. HHV-6 DNA was positive in both blood and cerebrospinal fluid samples. DWI at two months after onset showed atrophy in the left mesial temporal lobe and extratemporal and occipital lobe without the signal abnormalities. Although it has been reported that magnetic resonance images tend to show no acute abnormality during the first two days in typical AESD, transient reduced diffusion could be found on the DWI performed on the first day of AESD.
我们报告了一名13个月大的女孩，她在热性惊厥持续状态（FSE）作为急性脑病伴双相性癫痫发作和晚期扩散受限（AESD）的初始神经症状后的第一天进行了扩散加权成像（DWI），显示海马体和前连合处有短暂的扩散受限，随后发展为急性脑病伴双相性癫痫发作和晚期扩散受限（AESD）。晚期癫痫发作刚结束后的DWI显示左侧海马体、前连合以及左侧颞叶外和枕叶皮质下白质有高信号强度病变。血液和脑脊液样本中的人疱疹病毒6型（HHV-6）DNA均为阳性。发病两个月后的DWI显示左侧颞叶内侧、颞叶外和枕叶萎缩，无信号异常。尽管有报道称，在典型的AESD中，磁共振图像在前两天往往未显示急性异常，但在AESD第一天进行的DWI上可发现短暂的扩散受限。
