Acute encephalopathy with biphasic seizures and late reduced diffusion in a Spanish girl

Area of Science:

• Neurology
• Pediatrics
• Infectious Diseases

Background:

• Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is a rare neurological condition.
• Early diagnosis and understanding of AESD are crucial for patient outcomes.
• Biomarkers and neuroimaging play a key role in diagnosing and managing neurological disorders in children.

Observation:

• A 22-month-old Spanish girl presented with AESD, characterized by biphasic seizures and later diffusion restriction on MRI.
• Serum procalcitonin (PCT) levels peaked at 50.5 ng/mL on day 1, and C-reactive protein (CRP) peaked at 1.21 mg/dL on day 2.
• Neurological examination at discharge revealed persistent right spastic hemiparesis.

Findings:

• Magnetic resonance (MR) spectroscopy on day 23 showed decreased N-acetylaspartate and increased choline, indicating neuronal injury.
• The study highlights the potential utility of PCT and the PCT/CRP ratio in the early diagnosis of AESD.
• Correlation between MR spectroscopy findings and long-term neurological outcomes was observed.

Implications:

• This case represents the first reported instance of AESD in Europe.
• The findings suggest that PCT and CRP can serve as valuable early diagnostic markers for AESD.
• MR spectroscopy findings may help predict neurological deficits in patients with AESD, guiding clinical management and prognosis.