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[Reye's syndrome a clinical and electrophysiological study of four patients (author's transl)]
Insights
Serial EEGs aid Reye
Area of Science:
- Pediatric Neurology
- Hepatology
Background:
- Reye's syndrome is a severe condition affecting children, characterized by liver failure and coma.
- Key laboratory findings include elevated transaminases, hyperammoniaemia, and prolonged prothrombin time.
Observation:
- Four children with Reye's syndrome presented with severe liver failure and progressive coma.
- Electroencephalograms (EEGs) revealed generalized continuous delta activity in all patients.
Findings:
- Three of the four children survived with normalized liver function tests.
- Serial EEGs in two patients demonstrated a strong correlation between EEG improvement and clinical recovery.
- EEG monitoring is advocated for prognostic assessment in Reye's syndrome.
Implications:
- Hyperammoniaemia and elevated intracranial pressure are critical factors in Reye's syndrome pathogenesis.
- Controlling intracranial pressure is vital for improving patient prognosis.
- Serial EEG recordings offer valuable prognostic insights for Reye's syndrome management.
Abstract:
The authors studied four children with Reye's syndrome aged 16 months, 6 years, 8 years and 11 years respectively with severe liver failure and progressive coma. The laboratory investigations in all of them showed a marked elevation of serum transaminases, hyperammoniaemia and a prolongation of the prothrombin time. The electroencephalograms showed a grossly abnormal picture with generalised continuous delta activity. Three children survived with return to normal of the liver function tests whilst the fourth child died. In the last two patients an electroencephalogram carried out every six hours has enabled certain prognostic features to be determined. Improvement in the E.E.G. correlates closely with clinical improvement and vice versa. The authors also advocate serial E.E.G. recordings in Reye's syndrome. The role of hyperammonaemia in the genesis of encephalopathy and the electroencephalographic changed is discussed. The role played by raised intracranial pressure is stressed and the importance of controlling it in order to prevent further damage and improve the prognosis of this serious illness.