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Severe form of acute influenza encephalopathy with biphasic seizures and late reduced diffusion

H Tada1, J-i Takanashi, H Terada

  • 1Department of Pediatrics, Kameda Medical Center, Kamogawa, Japan.

Neuropediatrics
|August 2, 2008
PubMed

Insights

Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) presents with characteristic seizure patterns and diffusion changes. This case highlights a wider spectrum of AESD, including cerebral swelling and herniation, suggesting broader clinical and radiological variability.

Area of Science:

  • Neurology
  • Pediatric Neurology
  • Neuroradiology

Background:

  • Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a rare neurological disorder.
  • Typical AESD involves biphasic seizures and characteristic diffusion-weighted imaging findings.

Observation:

  • We present a case of clinically severe AESD in a Japanese child associated with influenza A.
  • Sequential magnetic resonance imaging (MRI) demonstrated cerebral swelling on day 1.
  • Further imaging revealed reduced diffusion and central herniation on day 6, followed by cortical laminar necrosis and atrophy on day 30.

Findings:

  • The patient exhibited a more severe and rapid progression of neurological symptoms than typically described in AESD.
  • MRI findings indicated significant cerebral edema, mass effect, and subsequent ischemic changes.
  • The observed timeline of radiological changes suggests a dynamic and potentially aggressive disease process.

Implications:

  • This case expands the known clinical and radiological spectrum of AESD.
  • It underscores the importance of early and serial neuroimaging in suspected AESD cases.
  • Further research is needed to understand the full range of AESD presentations and potential therapeutic strategies.

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