Incidence and risk factors of acute encephalopathy with biphasic seizures in febrile status epilepticus

被引：4

作者：

Ichinose, Fumio ^{[1
]}

Nakamura, Takuji ^{[1
,2
]}

Kira, Ryutaro ^{[3
]}

Furuno, Kenji ^{[4
]}

Ishii, Shigeki ^{[5
]}

Takamura, Kazunari ^{[5
]}

Hashiguchi, Marina ^{[6
]}

Inoue, Takushi ^{[7
]}

Senju, Ayako ^{[8
]}

Ichimiya, Yuko ^{[9
]}

Sakakibara, Takafumi ^{[10
]}

Sugiyama, Nobuyoshi ^{[11
]}

Naitou, Tomomi ^{[12
]}

Higuchi, Naoya ^{[1
,13
]}

Togawa, Masami ^{[14
]}

Torii, Ken-ichi ^{[15
]}

Toda, Soichiro ^{[16
]}

Iwamatsu, Hiroko ^{[17
]}

Sato, Tatsuharu ^{[18
]}

Tsurui, Satoshi ^{[19
]}

Tanaka, Hidenori ^{[20
]}

Motobayashi, Mitsuo ^{[21
]}

Abe, Akiko ^{[22
]}

Kawaguchi, Atsushi ^{[23
]}

Matsuo, Muneaki ^{[1
]}

机构：

[1] Saga Univ, Fac Med, Dept Pediat, Saga, Japan

[2] Natl Hosp Org Ureshino Med Ctr, Dept Pediat, Saga, Japan

[3] Fukuoka Childrens Hosp, Dept Pediat Neurol, Fukuoka, Japan

[4] Fukuoka Childrens Hosp, Dept Gen Med, Fukuoka, Japan

[5] Miyazaki Prefectural Miyazaki Hosp, Dept Pediat, Miyazaki, Japan

[6] Japan Org Occupat Hlth & Safety, Yokohama Rosai Hosp, Dept Pediat, Yokohama, Kanagawa, Japan

[7] Natl Hosp Org Okayama Med Ctr, Dept Pediat, Okayama, Japan

[8] Kitakyushu Gen Hosp, Dept Pediat, Fukuoka, Japan

[9] Kyushu Univ, Fac Med Sci, Dept Pediat, Fukuoka, Japan

[10] Nara Med Univ, Dept Pediat, Nara, Japan

[11] Tokai Univ, Sch Med, Dept Pediat, Hiratsuka, Kanagawa, Japan

[12] Saiseikai Kawaguchi Gen Hosp, Dept Pediat, Saitama, Japan

[13] Saga Prefectural Med Ctr Koseikan, Dept Pediat, Saga, Japan

[14] Tottori Prefectural Cent Hosp, Dept Pediat, Tottori, Japan

[15] Tokyo Metropolitan Otsuka Hosp, Dept Pediat, Tokyo, Japan

[16] Kameda Med Ctr, Dept Pediat, Chiba, Japan

[17] Oita Prefectural Hosp, Dept Pediat, Oita, Japan

[18] Nagasaki Univ Hosp, Dept Pediat, Nagasaki, Japan

[19] Seirei Numazu Hosp, Dept Pediat, Shizuoka, Japan

[20] Komaki City Hosp, Dept Pediat, Komaki, Aichi, Japan

[21] Nagano Childrens Hosp, Dept Pediat Neurol, Nagano, Japan

[22] Yamagata City Hosp Saiseikan, Dept Pediat, Yamagata, Japan

[23] Saga Univ, Educ & Res Ctr Community Med, Saga, Japan

来源：

BRAIN & DEVELOPMENT | 2022年 / 44卷 / 01期

关键词：

Encephalopathy; Status epilepticus; Febrile seizure; LATE REDUCED DIFFUSION; CONVULSIVE STATUS EPILEPTICUS; PROCALCITONIN; EPIDEMIOLOGY; CYCLOSPORINE; PREDICTION; CHILDREN; COHORT;

D O I：

10.1016/j.braindev.2021.07.004

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: To clarify the incidence and risk factors of acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) in pediatric patients with febrile status epilepticus (FSE). Methods: We retrospectively surveyed patients with FSE (>= 20 min and >= 40 min) who were younger than 6 years by mailing a questionnaire to 1123 hospitals in Japan. The survey period was 2 years. We then collected clinical data on patients with prolonged febrile seizures (PFS) >= 40 min and those with AESD, and compared clinical data between the PFS and AESD groups. Results: The response rate for the primary survey was 42.3%, and 28.0% of hospitals which had applicable cases responded in the secondary survey. The incidence of AESD was 4.3% in patients with FSE >= 20 min and 7.1% in those with FSE >= 40 min. In the second survey, a total of 548 patients had FSE >= 40 min (AESD group, n = 93; PFS group, n = 455). Univariate analysis revealed significant between-group differences in pH, aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, creatine kinase, NH3, procalcitonin (PCT), uric acid, blood urea nitrogen, creatinine (Cr), and lactate. Multivariate analysis using stratified values showed that high PCT was an only risk factor for AESD. A prediction score of >= 3 was indicative of AESD, as determined using the following indexes: HCO3(-) < 20 mmol/L (1 point), Cl <100 mEq/L (1 point), Cr >= 0.35 mg/dL (1 point), glucose >= 200 mg/dL (1 point), and PCT >= 1.7 pg/mL (2 points). The scoring system had sensitivity of 84.2% and specificity of 81.0%. Conclusion: Incidence data and prediction scores for AESD will be useful for future intervention trials for AESD. (C) 2021 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.

引用

页码：36 / 43

页数：8

共 27 条

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