Lee Keun Soo, Lee Bo Lyun, Heo Young Jin
Department of Neurosurgery, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Division of Pediatric Neurology, Department of Pediatrics, Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
Child Neurol Open. 2019 Feb 5;6:2329048X19826288. doi: 10.1177/2329048X19826288. eCollection 2019.
Acute encephalopathy with biphasic seizures and late reduced diffusion is a subtype of acute encephalopathy described in a cohort of Japanese children. Few cases have been reported in countries other than Japan. It is characterized clinically by biphasic seizures and late reduced subcortical diffusion on magnetic resonance imaging (MRI). We report the case of a 3-year-old Korean girl with acute encephalopathy with biphasic seizures and late reduced diffusion who presented with status epilepticus associated with fever and pneumonia. Human adenovirus was detected from a respiratory specimen using multiplex real-time reverse transcriptase polymerase chain reaction. After 5 days, she developed a second cluster of seizures followed by altered consciousness, aphasia, stereotypic movement, and developmental regression. Her brain MRI showed symmetrical and extensive restricted diffusion in the subcortical white matter, which finally resulted in global brain atrophy, consistent with acute encephalopathy with biphasic seizures and late reduced diffusion. Here, we report a case of acute encephalopathy with biphasic seizures and late reduced diffusion associated with preceding adenoviral pneumonia.
伴有双相性癫痫发作和晚期弥散受限的急性脑病是一组日本儿童中所描述的急性脑病的一种亚型。在日本以外的国家,仅有少数病例报道。其临床特征为双相性癫痫发作以及磁共振成像(MRI)显示的晚期皮质下弥散受限。我们报告了一名3岁韩国女孩的病例,她患有伴有双相性癫痫发作和晚期弥散受限的急性脑病,表现为与发热和肺炎相关的癫痫持续状态。通过多重实时逆转录聚合酶链反应从呼吸道标本中检测出人类腺病毒。5天后,她出现了第二组癫痫发作,随后出现意识改变、失语、刻板运动和发育倒退。她的脑部MRI显示皮质下白质有对称性广泛的弥散受限,最终导致全脑萎缩,符合伴有双相性癫痫发作和晚期弥散受限的急性脑病。在此,我们报告一例与先前腺病毒性肺炎相关的伴有双相性癫痫发作和晚期弥散受限的急性脑病病例。