Diffusion MRI abnormalities after prolonged febrile seizures with encephalopathy

Takanashi, Jun‐ichi; Oba, Hiroshi; Barkovich, A. James; Tada, Hayato; Tanabe, Yuzo; Yamanouchi, Hideo; Fujimoto, S.; Kato, Mitsuhiro; Kawatani, Masao; Sudo, Akira; Ozawa, Hiroshi; Okanishi, Tohru; Ishitobi, Mamiko; Maegaki, Yoshihiro; Koyasu, Yasuki

doi:10.1212/01.wnl.0000210487.36667.a5

Cited by 216 publications

(192 citation statements)

References 13 publications

Supporting

Mentioning

182

Contrasting

Order By: Relevance

“…In this study, central-sparing lesions were not observed in any patient within the first 3 days after onset, consistent with several previous reports. 3,[12][13][14]17 In contrast, frontal occipital lesions were recognized within the first 3 days after onset and were followed by diffuse lesions. Second, the distribution of brain lesions is different in the 2 situations.…”

Section: Discussionmentioning

confidence: 97%

“…A biphasic clinical course is characteristic of this group of patients, as described previously. 3 Several studies on acute encephalopathy have also reported a biphasic clinical course. [11][12][13][14] Onset is often marked by a prolonged seizure followed by improved consciousness.…”

Section: Discussionmentioning

confidence: 99%

“…The pathogenesis of acute encephalopathy with central-sparing lesions may be different from that of acute encephalopathy with diffuse lesions. Some authors have suggested that this subtype of acute encephalopathy is caused by excitotoxicity, 3,15 because prolonged seizures are often observed at the onset of AESD. MR spectroscopy has shown increased glutamate concentrations and decreased N-acetylaspartate levels in patients with AESD.…”

Section: Discussionmentioning

confidence: 99%

“…1 Clinically mild encephalitis/encephalopathy with a reversible splenial lesion is characterized by transient reduced diffusion in the splenium of the corpus callosum, with complete recovery. 2 Recently, Takanashi et al 3 described a form of acute encephalopathy characterized by biphasic seizures and late reduced diffusion (AESD). In patients with AESD, a seizure, especially a prolonged one, is commonly observed at onset.…”

mentioning

confidence: 99%

“…Furthermore, this subtype of acute encephalopathy is characterized by widespread reduced diffusion on MR imaging from 3 to 9 days after onset. Although the outcome of patients with AESD is reportedly very poor, 3 a milder form of AESD without neurologic sequelae has also been described. 4 It is interesting that all reported cases of children with AESD have been of in those of East Asian descent.…”

mentioning

confidence: 99%

See 4 more Smart Citations

Differences of Clinical Manifestations According to the Patterns of Brain Lesions in Acute Encephalopathy with Reduced Diffusion in the Bilateral Hemispheres

Okumura¹,

Kidokoro²,

Tsuji³

et al. 2009

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

mentioning

confidence: 99%

See 3 more Smart Citations

Differences of Clinical Manifestations According to the Patterns of Brain Lesions in Acute Encephalopathy with Reduced Diffusion in the Bilateral Hemispheres

Okumura¹,

Kidokoro²,

Tsuji³

et al. 2009

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

show abstract

Brain dysfunction in COVID‐19 and CAR‐T therapy: cytokine storm‐associated encephalopathy

Pensato

Muccioli

Cani

et al. 2021

Ann Clin Transl Neurol

View full text Add to dashboard Cite

Objective Many neurological manifestations are associated with COVID‐19, including a distinct form of encephalopathy related to cytokine storm, the acute systemic inflammatory syndrome present in a subgroup of COVID‐19 patients. Cytokine storm is also associated with immune effector cell‐associated neurotoxicity syndrome (ICANS), a complication of chimeric antigen receptor T‐cell (CAR‐T) therapy, a highly effective treatment for refractory hematological malignancies. We investigated whether COVID‐19‐related encephalopathy, ICANS, and other encephalopathies associated with cytokine storm, share clinical and investigative findings. Methods Narrative literature review. Results Comparisons between COVID‐19‐related encephalopathy and ICANS revealed several overlapping features. Clinically, these included dysexecutive syndrome, language disturbances, akinetic mutism and delirium. EEG showed a prevalence of frontal abnormalities. Brain MRI was often unrevealing. CSF elevated cytokine levels have been reported. A direct correlation between cytokine storm intensity and severity of neurological manifestations has been shown for both conditions. Clinical recovery occurred spontaneously or following immunotherapies in most of the patients. Similar clinical and investigative features were also reported in other encephalopathies associated with cytokine storm, such as hemophagocytic lymphohistiocytosis, sepsis, and febrile infection‐associated encephalopathies. Interpretation COVID‐19‐related encephalopathy and ICANS are characterized by a predominant electro‐clinical frontal lobe dysfunction and share several features with other encephalopathies associated with cytokine storm, which may represent the common denominator of a clinical spectrum of neurological disorders. Therefore, we propose a unifying definition of cytokine storm‐associated encephalopathy (CySE), and its diagnostic criteria.

show abstract

Cytokine and chemokine responses in the blood and cerebrospinal fluid of patients with human herpesvirus 6B‐associated acute encephalopathy with biphasic seizures and late reduced diffusion

Kawamura

Yamazaki

Ohashi

et al. 2013

Journal of Medical Virology

View full text Add to dashboard Cite

Acute encephalopathy with biphasic seizures and late reduced diffusion has become increasingly common among various types of human herpesvirus 6B (HHV-6B) encephalitis at the time of primary viral infection. The aim of the present study is to explore the pathophysiology of HHV-6B-associated acute encephalopathy with biphasic seizures and late reduced diffusion. Five cytokines and five chemokines were measured in serum and cerebrospinal fluid (CSF) obtained from 12 HHV-6B-associated acute encephalopathy with biphasic seizures and late reduced diffusion patients and 19 control exanthem subitum (without complications) patients. Serum interleukin (IL)-10 (P = 0.007) and IL-8 (P = 0.025) were significantly higher in the patients with the disease than controls. Serum IL-1β (P = 0.034) and monocyte chemoattractant protein (MCP)-1 (P = 0.002) were significantly higher in the controls than patients with the disease. In patients with the disease, IL-10 (P = 0.012), regulated on activation normal T cell expressed and secreted (RANTES; P = 0.001), and monokine induced by interferon γ (MIG; P = 0.001) were significantly higher in serum than CSF, meanwhile IL-6 (P = 0.034), IL-8 (P = 0.034), and MCP-1 (P = 0.001) were significantly higher in CSF than serum. Additionally, serum IL-10 was significantly higher in the disease patients with sequelae than those without sequelae (P = 0.016). Several cytokines and chemokines may be associated with the pathogenesis of acute encephalopathy with biphasic seizures and late reduced diffusion. Moreover, the regulation of cytokine networks appears to be different between peripheral blood (systemic) and central nervous system.

show abstract

Diffusion MRI abnormalities after prolonged febrile seizures with encephalopathy

Abstract: Although the pathophysiologic mechanism remains unknown, these patients seem to have a distinctive encephalopathy syndrome. MRI is helpful in establishing the diagnosis of this encephalopathy.

Cited by 216 publications

References 13 publications

Differences of Clinical Manifestations According to the Patterns of Brain Lesions in Acute Encephalopathy with Reduced Diffusion in the Bilateral Hemispheres

Differences of Clinical Manifestations According to the Patterns of Brain Lesions in Acute Encephalopathy with Reduced Diffusion in the Bilateral Hemispheres

Brain dysfunction in COVID‐19 and CAR‐T therapy: cytokine storm‐associated encephalopathy

Cytokine and chemokine responses in the blood and cerebrospinal fluid of patients with human herpesvirus 6B‐associated acute encephalopathy with biphasic seizures and late reduced diffusion

Contact Info

Product

Resources

About