Acute Encephalopathy With Biphasic Seizures and Late Reduced Diffusion Associated With Adenoviral Pneumonia

Area of Science:

• Pediatric Neurology
• Infectious Diseases

Background:

• Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a rare neurological disorder primarily reported in Japanese children.
• AESD is characterized by recurrent seizures and characteristic diffusion restriction in the subcortical white matter on MRI, often leading to significant neurological deficits.

Observation:

• A 3-year-old Korean girl presented with status epilepticus, fever, and pneumonia.
• Human adenovirus was identified as the causative agent.
• Following initial symptoms, she experienced a second seizure cluster, altered consciousness, aphasia, and developmental regression.

Findings:

• Brain MRI revealed symmetrical, extensive restricted diffusion in the subcortical white matter.
• These findings progressed to global brain atrophy, consistent with AESD.
• The case highlights a potential association between adenoviral pneumonia and AESD.

Implications:

• This case expands the geographic and etiological understanding of AESD.
• It underscores the importance of considering viral infections, such as adenovirus, in the differential diagnosis of acute encephalopathy in children.
• Further research is needed to elucidate the pathogenesis and long-term outcomes of AESD in diverse populations.