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Acute Leucoencephalopathy with Restricted Diffusion in Children - A case series

Mahesh Kamate1, Mayank Detroja2, Virupaxi Hattiholi3

  • 1Professor of Pediatrics and In.Charge Child Development Centre, KAHER University's J N Medical College, Belgaum, Karnataka, India.

Neurology India
|April 27, 2021
PubMed

Insights

Acute leukoencephalopathy with restricted diffusion is a significant cause of childhood encephalopathy, often leading to prolonged illness and lasting neurological issues like cognitive impairment and epilepsy.

Area of Science:

  • Pediatric Neurology
  • Neuroimaging
  • Infectious Diseases

Background:

  • Acute leukoencephalopathy with restricted diffusion (ALERD) is an emerging neurological condition in children.
  • Understanding its clinical and radiological features is crucial for diagnosis and management.

Purpose of the Study:

  • To investigate the clinico-radiological profile of pediatric ALERD.
  • To analyze the outcomes and sequelae in affected children.

Main Methods:

  • Retrospective chart review of 16 children diagnosed with ALERD between July 2015 and July 2018.
  • Analysis of clinical data, neuroimaging findings (MRI), and modified Rankin Scores.

Main Results:

  • The study included 16 children (mean age 4.4 years) with ALERD, predominantly presenting with fever, seizures, and altered sensorium.
  • MRI revealed diffusion restriction in all cases, with varied symmetry.
  • Significant sequelae included post-encephalopathic epilepsy (43.7%), behavioral problems (62.5%), speech issues (50%), and cognitive delay (18.8%).

Conclusions:

  • ALERD is an important cause of acute encephalopathy in children, characterized by a protracted course.
  • Long-term sequelae such as cognitive impairment and refractory epilepsy are common, necessitating further research and management strategies.
Abstract

Keywords:
Acute encephalopathy with biphasic seizures and restricted diffusionacute leukoencephalopathy with restricted diffusionneuroimagingpost-encephalopathic epilepsy

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