[P1-20] Acute encephalopathy cases over the past six-and-a-half years at Osaka Red Cross Hospital adjuncted a facility for severely challenged people
Acute encephalopathy is rare and can sometimes be fatal. We reviewed Osaka Red Cross Hospital (ORCH) cases and report on their characteristics.
We identified 19 cases of acute encephalopathy from January 1st, 2010, until October 31st, 2016. The types of acute encephalopathy were determined by the “Pediatric Acute Encephalopathy Guidelines 2016” edited by the Japanese Society of Child Neurology.
We identified six cases of acute encephalopathy with biphasic seizures and late reduced diffusion, five cases of hemorrhagic shock and encephalopathy syndrome (HSES), two clinically mild cases of encephalitis/encephalopathy with a reversible splenial lesion (MERS), one case of acute encephalitis with refractory and repetitive partial seizures, and five cases of unclassifiable encephalopathy. Etiologies of the identified cases were infection (63%) and undetermined (37%).
Compared with the “Nationwide survey of acute encephalopathy in Japan” conducted by Mizuguchi et al., our review included more cases of HSES and fewer cases of MERS. Additionally, influenza virus was less frequently detected in the etiology.
We found nine cases with underlying central nervous system disorders, such as cerebral palsy, motor or mental retardation, and epilepsy. Furthermore, four out of five cases of HSES had central nervous disorder(s).
Laboratory findings did not predict the type of each encephalopathy. Mortality was 16%, while neurological complications included palsy, motor or mental retardation, epilepsy, and higher brain dysfunction.
Because of the relatively large population of severely challenged patients at ORCH, cases of acute encephalopathy may continue to be prevalent. Therefore, establishing standardized and effective treatment is an emergent concern.
We identified 19 cases of acute encephalopathy from January 1st, 2010, until October 31st, 2016. The types of acute encephalopathy were determined by the “Pediatric Acute Encephalopathy Guidelines 2016” edited by the Japanese Society of Child Neurology.
We identified six cases of acute encephalopathy with biphasic seizures and late reduced diffusion, five cases of hemorrhagic shock and encephalopathy syndrome (HSES), two clinically mild cases of encephalitis/encephalopathy with a reversible splenial lesion (MERS), one case of acute encephalitis with refractory and repetitive partial seizures, and five cases of unclassifiable encephalopathy. Etiologies of the identified cases were infection (63%) and undetermined (37%).
Compared with the “Nationwide survey of acute encephalopathy in Japan” conducted by Mizuguchi et al., our review included more cases of HSES and fewer cases of MERS. Additionally, influenza virus was less frequently detected in the etiology.
We found nine cases with underlying central nervous system disorders, such as cerebral palsy, motor or mental retardation, and epilepsy. Furthermore, four out of five cases of HSES had central nervous disorder(s).
Laboratory findings did not predict the type of each encephalopathy. Mortality was 16%, while neurological complications included palsy, motor or mental retardation, epilepsy, and higher brain dysfunction.
Because of the relatively large population of severely challenged patients at ORCH, cases of acute encephalopathy may continue to be prevalent. Therefore, establishing standardized and effective treatment is an emergent concern.