Acute encephalopathy with biphasic seizures and late reduced diffusion in Kawasaki disease

Area of Science:

• Pediatric Neurology
• Infectious Diseases
• Neuroimaging

Background:

• Kawasaki disease (KD) is a critical pediatric illness.
• Neurological complications of KD are not fully understood.
• Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a severe neurological condition.

Observation:

• A 7-month-old infant with Kawasaki disease presented with fever, status epilepticus, and cluster seizures.
• Neurological deterioration included severe disturbance of consciousness.
• Diffusion-weighted MRI revealed diffuse high signals in bilateral subcortical white matter.

Findings:

• Electroencephalogram showed low-voltage slow waves, indicative of significant brain dysfunction.
• The clinical and imaging findings were consistent with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD).
• This represents the first reported instance of AESD complicating Kawasaki disease.

Implications:

• This case expands the spectrum of neurological complications associated with Kawasaki disease.
• AESD in KD patients can lead to severe and persistent neurological sequelae.
• Early recognition and management of neurological complications in KD are crucial.