[P1-32] Chronological Changes of Brain MRI and Clinical Outcome in Acute Necrotizing Encephalopathy of Childhood
[Introduction] Acute necrotizing encephalopathy of childhood (ANEC) is a severe acute encephalopathy after viral infection-related febrile illness. The clinical outcome of ANEC has been historically poor. We aim to assess chronological changes of brain magnetic resonance imaging (MRI) and clinical outcome in ANEC.
[Methodology] From year 2010 to 2016, 5 patients, 3 males and 2 females, diagnosed with ANEC were assessed. In our case series, the neuroimaging diagnostic criteria of ANEC were multiple, symmetrical lesions on T2-weighted imaging in the thalami, with accompanying lesions in the brainstem tegmentum, periventricular white matter, putamen, and cerebellum. Follow-up brain MRI and clinical outcome were assessed.
[Results] The age of disease onset was from 3 to 9 years. Antecedent illness included acute gastroenteritis or upper respiratory tract infection. Clinically, acute deterioration of consciousness level or seizures occurred rapidly. Causative agents were influenza B virus, swine influenza virus, and rotavirus in 3 patients, and unknown in 2. Follow-up brain MRIs showed that all 5 patients exhibited involved areas at acute stage evolving to encephalomalacia with cystic changes. Regarding the clinical outcomes, two patients were ambulatory but left with neurological sequelae of left hand tremor and bilateral exotropia, respectively. Three patients were confined to bed.
[Conclusions] The characteristic finding of chronologic changes of brain MRI in patients with ANEC was encephalomalacia. Patients with ANEC might show a better outcome.
[Methodology] From year 2010 to 2016, 5 patients, 3 males and 2 females, diagnosed with ANEC were assessed. In our case series, the neuroimaging diagnostic criteria of ANEC were multiple, symmetrical lesions on T2-weighted imaging in the thalami, with accompanying lesions in the brainstem tegmentum, periventricular white matter, putamen, and cerebellum. Follow-up brain MRI and clinical outcome were assessed.
[Results] The age of disease onset was from 3 to 9 years. Antecedent illness included acute gastroenteritis or upper respiratory tract infection. Clinically, acute deterioration of consciousness level or seizures occurred rapidly. Causative agents were influenza B virus, swine influenza virus, and rotavirus in 3 patients, and unknown in 2. Follow-up brain MRIs showed that all 5 patients exhibited involved areas at acute stage evolving to encephalomalacia with cystic changes. Regarding the clinical outcomes, two patients were ambulatory but left with neurological sequelae of left hand tremor and bilateral exotropia, respectively. Three patients were confined to bed.
[Conclusions] The characteristic finding of chronologic changes of brain MRI in patients with ANEC was encephalomalacia. Patients with ANEC might show a better outcome.