[P1-25] Monitoring the Amplitude-integrated Electroencephalography in Acute Encephalopathy with Biphasic Seizures and Late Reduced Diffusion
Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a syndrome of encephalopathy characterized by biphasic seizures and altered consciousness in the acute stage followed in the subacute stage by restricted diffusion in the subcortical white matter on magnetic resonance imaging. It presents as a prolonged febrile seizure followed by a subsequent cluster of seizures several days later (biphasic seizures). The presence of subclinical seizures recognized by amplitude-integrated electroencephalography (aEEG) monitoring has been described in patients with AESD during the subsequent cluster of seizures. We report three cases of AESD with continuous aEEG monitoring during the period of clustered seizures. In one of the cases, the frequent apneic episodes with oxygen desaturation due to clustered seizures were recognized. Although the seizures disappeared with continuous intravenous midazolam, subclinical seizures, which stopped when the midazolam dose was increased, were seen on aEEG monitoring. In the other two cases, continuous aEEG monitoring was useful for evaluating the efficacy of anticonvulsants after the clinical seizures had disappeared. These cases suggest that continuous aEEG monitoring is helpful for monitoring subclinical seizures and evaluate the effectiveness of anticonvulsant drugs during the period of subsequent seizure clusters in AESD.