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[Acute encephalopathy with biphasic seizures and late reduced diffusion with visual disturbance and higher brain
Saeko Morino1, Tomohide Goto, Ushio Ohtaki
1Department of Neurology, Tokyo Metropolitan Kiyose Children's Hospital, Kiyose, Tokyo. saeko_morino@tmhp.jp
No to Hattatsu = Brain and Development
|August 2, 2011
Summary
Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) can present with occipital lobe involvement. This case highlights a variant of AESD with distinct MRI findings and visual disturbances.
Area of Science:
- Neurology
- Radiology
- Pediatrics
Background:
- Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a recognized neurological syndrome.
- AESD typically involves frontoparietal subcortical white matter lesions on MRI.
- Consciousness disturbance is a key symptom between initial and subsequent seizures.
Observation:
- A 2-year-old girl presented with visual disturbance following a febrile seizure.
- Subsequent seizures and MRI revealed reduced diffusion predominantly in the occipital lobe.
- Visual disturbances were reversible, followed by cognitive and speech deficits.
Findings:
- The patient's MRI findings were atypical for AESD, with occipital lobe dominance.
- Normal ophthalmologic exams contrasted with abnormal visual evoked potentials.
- This suggested subcortical white matter visual pathway impairment.
Implications:
- This case suggests a subgroup of AESD with occipital lobe predilection.
- Recognizing this variant is crucial for accurate diagnosis and management.
- Further research may elucidate the specific pathophysiology of occipital AESD.
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