Short and long-term outcomes in children with suspected acute encephalopathy
Short and long-term outcomes in children with suspected acute encephalopathy
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DOI：
10.1016/j.braindev.2016.02.011
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发表时间：
2016-09-01
影响因子：
1.7
通讯作者：
Iijima, Kazumoto
中科院分区：
文献类型：
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作者：
Nishiyama, Masahiro;Nagase, Hiroaki;Iijima, Kazumoto
背景：急性脑病后儿童发生的随时间变化的情况尚不清楚。因此，我们评估了疑似急性脑病后脑功能随时间的变化。方法：我们创建了 2002 年至 2013 年间因惊厥或意识障碍伴发烧而入住神户儿童医院儿科重症监护室的儿童数据库。回顾了临床过程和结果，符合以下标准的患者纳入研究：(1) 6 个月至 15 岁，(2) 发病前无神经系统异常，(3) 因疑似急性脑病接受治疗脑病，(4) 在发病 1 (0-2) 个月和 12 (10-17) 个月后进行随访。使用儿科脑功能类别（PCPC）量表评估结果，1分代表正常表现； 2、轻度残疾； 3、中度残疾； 4、严重残疾； 5、植物人状态； 6，脑死亡。 结果：共有 78 名儿童（32 名男性）入组，发病年龄中位（范围）为 20（6-172）个月。出院时，51 例 PCPC 得分为 1，13 例得分为 2，3 例得分为 3，5 例得分为 4，1 例得分为 5，5 例得分为 6。 13 名 PCPC 得分为 2 的病例中，有 7 名在 12 个月后恢复了正常脑功能，而 PCPC 得分为 3-5 的 9 名病例中没有一人恢复了正常功能。 结论：我们的研究结果表明，急性脑病引起的中度至重度残疾会对脑功能产生持久影响，而轻度残疾可能会导致功能改善。 (C) 2016 年日本儿童神经病学学会。由 Elsevier B.V. 出版。保留所有权利。
Background: The time-dependent changes that occur in children after acute encephalopathy are not clearly understood. Therefore, we assessed changes in brain function after suspected acute encephalopathy over time.Methods: We created a database of children admitted to the pediatric intensive care unit at Kobe Children's Hospital because of convulsions or impaired consciousness with fever between 2002 and 2013. Clinical courses and outcomes were reviewed and patients who met the following criteria were included in the study: (1) 6 months to 15 years of age, (2) no neurological abnormality before onset, (3) treated for suspected acute encephalopathy, and (4) followed after 1 (0-2) month and 12 (10-17) months of onset. Outcomes were assessed using the Pediatric Cerebral Performance Category (PCPC) scale, with a score of 1 representing normal performance; 2, mild disability; 3, moderate disability; 4, severe disability; 5, vegetative state; and 6, brain death.Results: A total of 78 children (32 male) with a median (range) age at onset of 20 (6-172) months were enrolled. Fifty-one cases scored 1 on the PCPC, 13 scored 2, three scored 3, five scored 4, one scored 5, and five cases scored 6 at discharge. Whereas seven of the 13 cases that scored a 2 on the PCPC recovered normal brain function after 12 months, none of the nine cases that scored a 3-5 on the PCPC recovered normal function.Conclusions: Our findings suggest moderate to severe disability caused by acute encephalopathy had lasting consequences on brain function, whereas mild disability might result in improved function. (C) 2016 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.