Palkrit Sakshi, Bhakaney Pallavi, Kumbhare Ruhi, Vardhan Vishnu
Physical Therapy, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Cardiorespiratory Physiotherapy, Datta Meghe Institute of Medical Sciences, Wardha, IND.
Cureus. 2022 Oct 17;14(10):e30408. doi: 10.7759/cureus.30408. eCollection 2022 Oct.
Acute necrotizing encephalopathy, also known as acute necrotizing encephalopathy of childhood (ANEC) is a rare disorder characterized by respiratory or gastrointestinal infections, high fever, and rapid changes in consciousness and seizures. ANEC is a rare form of encephalopathy characterized by multiple bilateral brain lesions, primarily involving the thalami and putamina internal and external capsules, cerebellar white matter, and the brainstem segmentum. Here we present, a rare case of acute necrotizing encephalopathy in a pediatric patient, a 13-year-old boy, who was admitted with acute onset of fever. The fever was intermittent and high grade along with chills, rigor, and respiratory distress five days back. The chest x-ray showed heterogeneous opacities in bilateral lung fields. Thalami, brainstem, cerebellum, and white matter have all been shown to have a symmetric lesion in this disease on magnetic resonance imaging (MRI). Ventilation, immunoglobulin, and other supporting measures, as well as respiratory rehabilitation, were used to treat him. In pediatric intensive care units (PICU), physiotherapy is considered an important aspect of patient care. Respiratory rehabilitation included patients and their family member's counseling, airway clearance techniques, energy conservation methods, and adaptation to complex positions with the maintenance of oxygen saturation (SpO). We conclude Respiratory rehabilitation with efficient family counseling is effective in the overall improvement of the patient's condition with acute respiratory failure in acute necrotizing encephalopathy.
急性坏死性脑病，也称为儿童急性坏死性脑病（ANEC），是一种罕见的疾病，其特征为呼吸道或胃肠道感染、高热以及意识快速改变和癫痫发作。ANEC是一种罕见的脑病形式，其特征为双侧大脑多处病变，主要累及丘脑、壳核内外囊、小脑白质和脑干节段。在此，我们报告一例罕见的儿科急性坏死性脑病病例，患者为一名13岁男孩，因急性发热入院。五天前，发热呈间歇性且高热，伴有寒战、抽搐和呼吸窘迫。胸部X线显示双侧肺野有不均匀的模糊阴影。在磁共振成像（MRI）上，该疾病的丘脑、脑干、小脑和白质均显示有对称性病变。采用了通气、免疫球蛋白及其他支持措施以及呼吸康复治疗。在儿科重症监护病房（PICU），物理治疗被视为患者护理的一个重要方面。呼吸康复包括对患者及其家属的咨询、气道清理技术、节能方法以及在维持血氧饱和度（SpO）的情况下适应复杂体位。我们得出结论，有效的家属咨询结合呼吸康复对于急性坏死性脑病急性呼吸衰竭患者的整体病情改善是有效的。
