Efficacy of hypothermia therapy in patients with acute encephalopathy with biphasic seizures and late reduced diffusion
Efficacy of hypothermia therapy in patients with acute encephalopathy with biphasic seizures and late reduced diffusion
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DOI：
10.1016/j.braindev.2020.03.007
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发表时间：
2020-08-01
影响因子：
1.7
通讯作者：
Hasegawa, Shunji
中科院分区：
文献类型：
--
作者：
Hoshide, Madoka;Yasudo, Hiroki;Hasegawa, Shunji
背景资料：急性脑病伴双相癫痫发作和迟发性弥散减低（AESD）的特征是双相癫痫发作和意识障碍。AESD患者的低温/常温治疗的疗效很少报道。方法：我们招募了2005年至2019年在山口大学医院和山口县生会下关综合医院住院的15例AESD患者，并回顾性评价了低温治疗与非低温治疗的长期疗效。我们比较了AESD患者接受或不接受低温治疗的长期后遗症。我们使用小儿脑功能分类（PCPC）量表和智力测试，包括韦氏儿童智力量表，田中-比奈智力量表和Enjoji婴儿发育量表，以评估神经系统后遗症和精神残疾。根据脑病后癫痫（PEE.Results）的发展评估亚低温治疗的预防效果：PCPC评分组间差异无统计学意义（p = 0.53）。亚低温治疗组中重度精神残疾者为0例（0%），非亚低温治疗组中重度精神残疾者为2例（29%），但差异无显著性。值得注意的是，有没有患者在低温治疗组发生PEE，而有4（57.1%）在非低温组（p = 0.03）。结论：我们的研究表明，低温治疗可能是有效的AESD的长期后遗症，在防止PEE的发展。我们认为，低温治疗可以通过预防随后发生的PEE来改善这些患者的生活质量。(C)2020日本儿童神经病学学会。Elsevier B. V.出版，保留所有权利。
Background: Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is characterized by biphasic seizures and impaired consciousness. The efficacy of hypothermia/normothermia therapy in patients with AESD has rarely been reported on.Methods: We enrolled 15 patients with AESD admitted to Yamaguchi University Hospital and Yamaguchi-ken Saiseikai Shimonoseki General Hospital between 2005 and 2019 and retrospectively evaluated the long-term efficacy of hypothermia therapy compared to that of non-hypothermia therapy. We compared the long-term sequelae of patients with AESD treated with or without hypothermia therapy. We used the Pediatric Cerebral Performance Category (PCPC) scale and intelligence tests including the Wechsler Intelligence Scale for Children, Tanaka-Binet Intelligence Scale, and Enjoji Infantile Developmental Scale to evaluate neurological sequelae and mental disability. The preventive effect of hypothermia therapy was assessed based on the development of post-encephalopathic epilepsy (PEE).Results: There was no significant between-group difference in the PCPC score (p = 0.53). The subjects with severe mental disability in the hypothermia therapy group were 0 (0%), while those in the non-hypothermia group were 2 (29%); however, the difference was not significant. Notably, there were no patients with onset of PEE in the hypothermia therapy group, while there were 4 (57.1%) in the non-hypothermia group (p = 0.03).Conclusions: Our study suggests that hypothermia therapy may be effective in the long-term sequelae of AESD in terms of preventing the development of PEE. We propose that hypothermia therapy could contribute to improve the quality of life in these patients by preventing the subsequent onset of PEE. (C) 2020 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.