Efficacy of hypothermia therapy in patients with acute encephalopathy with biphasic seizures and late reduced diffusion

Hoshide, Madoka; Yasudo, Hiroki; Inoue, Hirofumi; Matsushige, Takeshi; Sakakibara, Ayumi; Nawata, Yoshiko; Hidaka, Ippei; Kobayashi, Hikaru; Kohno, Fumitaka; Ichiyama, Takashi; Hirano, Reiji; Hasegawa, Shunji

doi:10.1016/j.braindev.2020.03.007

Cited by 8 publications

(10 citation statements)

References 13 publications

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“…PEE has been reported to occur 2 to 39 months after AESD and often involves multiple seizure types which are difficult to control. 2,12 Here, 1 case resulted in withdrawal of care, whereas the remaining 2 had significant morbidities and 1 developed PEE, which may reflect the relatively late diagnosis of AESD in our practice. Nevertheless, it still remains to be determined whether AESD represents a disease spectrum that impacts severity and outcomes.…”

Section: Discussionmentioning

confidence: 87%

“…11 Magnetic resonance spectroscopy (MRS) studies of children with AESD further support this hypothesis. 10,11 Inhibition of glutamate release by hypothermia or cooling has shown efficacy in AESD patients 10,12 and hypothermia has antiepileptic effects. 7 While there is some evidence for the beneficial effect of early temperature regulation within 6 hours of symptoms onset in AESD, 10,12 treating patients prior to identifying an etiology may result in many patients being unnecessarily cooled.…”

Section: Discussionmentioning

confidence: 99%

“…10,11 Inhibition of glutamate release by hypothermia or cooling has shown efficacy in AESD patients 10,12 and hypothermia has antiepileptic effects. 7 While there is some evidence for the beneficial effect of early temperature regulation within 6 hours of symptoms onset in AESD, 10,12 treating patients prior to identifying an etiology may result in many patients being unnecessarily cooled. Yokochi and colleagues 4 initiated therapeutic hypothermia following the second seizure onset and concluded that as therapeutic hypothermia was associated with a good outcome in 50% of patients, temperature regulation might still be effective even if initiated later in the disease course.…”

Section: Discussionmentioning

confidence: 99%

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Pediatric Encephalopathy and Complex Febrile Seizures

Yaworski

Alobaidi

Liu

et al. 2022

Clin Pediatr (Phila)

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pediatric Encephalopathy and Complex Febrile Seizures

Yaworski

Alobaidi

Liu

et al. 2022

Clin Pediatr (Phila)

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“…Hypothermia therapy may be useful in preventing the development of post-encephalopathic epilepsy (PEE) in the long-term consequences of AESD. Hypothermia therapy could help these patients enhance their quality of life by preventing the development of PEE [ 74 ]. Mild brain hypothermia therapy, followed by targeted temperature management, may be an effective way to improve neurological outcomes in children with HSES [ 75 ].…”

Section: Managementmentioning

confidence: 99%

“…The question then becomes how long after the onset of the disease should a neurological prognosis be made and in what manner. According to recent reports, the timing of the assessment of neurological prognosis varies depending on the study design [ 66 , 74 , 79 , 101 ]. The Pediatric Cerebral Performance Category (PCPC) scale is the most commonly used scale for assessing disability in pediatric sequelae.…”

Section: How To Evaluate Neurological Prognosismentioning

confidence: 99%

A Comprehensive Review of Pediatric Acute Encephalopathy

Imataka

Kuwashima

Yoshihara

2022

JCM

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Acute encephalopathy typically affects previously healthy children and often results in death or severe neurological sequelae. Acute encephalopathy is a group of multiple syndromes characterized by various clinical symptoms, such as loss of consciousness, motor and sensory impairments, and status convulsions. However, there is not only localized encephalopathy but also progression from localized to secondary extensive encephalopathy and to encephalopathy, resulting in a heterogeneous clinical picture. Acute encephalopathy diagnosis has advanced over the years as a result of various causes such as infections, epilepsy, cerebrovascular disorders, electrolyte abnormalities, and medication use, and new types of acute encephalopathies have been identified. In recent years, various tools, including neuroradiological diagnosis, have been developed as methods for analyzing heterogeneous acute encephalopathy. Encephalopathy caused by genetic abnormalities such as CPT2 and SCN1A is also being studied. Researchers were able not only to classify acute encephalopathy from image diagnosis to typology by adjusting the diffusion-weighted imaging/ADC value in magnetic resonance imaging diffusion-weighted images but also fully comprehend the pathogenesis of vascular and cellular edema. Acute encephalopathy is known as a very devastating disease both medically and socially because there are many cases where lifesaving is sometimes difficult. The overall picture of childhood acute encephalopathy is becoming clearer with the emergence of the new acute encephalopathies. Treatment methods such as steroid pulse therapy, immunotherapy, brain hypothermia, and temperature control therapy have also advanced. Acute encephalopathy in children is the result of our predecessor’s zealous pursuit of knowledge. It is reasonable to say that it is a field that has advanced dramatically over the years. We would like to provide a comprehensive review of a pediatric acute encephalopathy, highlighting advancements in diagnosis and treatment based on changing disease classification scenarios from the most recent clinical data.

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