[SP5-3C-4] Factors associated with long-term neurological outcomes after acute childhood encephalopathy: A retrospective study of 74 cases.
[Objective] To analyze long-term neurological outcomes of childhood acute encephalopathy and identify possible prognostic factors. [Methods] A retrospective review of patients with acute encephalopathy who had undergone rehabilitation at Takuto Rehabilitation Center for Children between January 2005 and December 2015. Multivariate logistic regression analysis was used to analyze factors associated with long-term neurological outcomes, especially in Gross motor function classification system (GMFCS), Communication function classification system (CFCS), Manual ability classification system (MACS), and intractable epilepsy. [Results] We identified 74 patients (32 [43.2%] men) with a median onset age of 19 months (range 0.5–111). In this case series, the number of patients with poor outcomes (Level IV/V of GMFCS, CFCS, MACS and intractable epilepsy) are 32 (43.3%), 40 (54.1%), 39 (52.7%) and 19 (25.7%) respectively. On multivariate regression analysis, thyrotropin-releasing hormone (TRH) therapy is the factor associated with favorable outcomes defined as GMFCS, CFCS, and MACS levels are all I, II, or III [adjusted odds ratio (aOR), 6.48; 95% confidence interval (95% CI), 2.02–20.8] and past history of afebrile seizure before onset [aOR, 12.9; 95% CI, 1.91-86.7] and 4 or more antiepileptic drugs usage in acute phase [aOR, 6.61; 95% CI, 1.53-28.5] are risk factors associated with intractable epilepsy. [Conclusions] TRH therapy may be a favorable prognostic factor of neurological outcomes, while past history of afebrile seizure and many antiepileptic drugs usage may be the risk factors of intractable epilepsy after acute childhood encephalopathy.