Early administration of vitamins B1 and B6 and l-carnitine prevents a second attack of acute encephalopathy with biphasic seizures and late reduced diffusion: A case control study

Fukui, Kana; Kubota, Masaya; Terashima, Hiroshi; Ishiguro, Akira; Kashii, Hirofumi

doi:10.1016/j.braindev.2019.02.015

Cited by 24 publications

(22 citation statements)

References 14 publications

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“…Supplementation of thiamine is essential in rare disorders of thiamine metabolism and transport [119][120][121] and in Wernicke encephalopathy [122], a condition due to vitamin B 1 deficiency that was recently reported in children taking an excessive amount of ionic drinking water. As an efficacy in AE, a recent study suggested that a combination of vitamin B 1 , B 6 and carnitine may reduce the risk of AESD [123]. Carnitine binds to long chain acyl CoA and transports it from the cytoplasm to the mitochondria.…”

Section: Commentsmentioning

confidence: 99%

Guidelines for the diagnosis and treatment of acute encephalopathy in childhood

Mizuguchi

Ichiyama

Imataka

et al. 2021

Brain and Development

137

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The cardinal symptom of acute encephalopathy is impairment of consciousness of acute onset during the course of an infectious disease, with duration and severity meeting defined criteria. Acute encephalopathy consists of multiple syndromes such as acute necrotizing encephalopathy, acute encephalopathy with biphasic seizures and late reduced diffusion and clinically mild encephalitis/ encephalopathy with reversible splenial lesion. Among these syndromes, there are both similarities and differences. In 2016, the Japanese Society of Child Neurology published 'Guidelines for the Diagnosis and Treatment of Acute Encephalopathy in Childhood', which made recommendations and comments on the general aspects of acute encephalopathy in the first half, and on individual syndromes in the latter half. Since the guidelines were written in Japanese, this review article describes extracts from the recommendations and comments in English, in order to introduce the essence of the guidelines to international clinicians and researchers.

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Section: Commentsmentioning

confidence: 99%

Guidelines for the diagnosis and treatment of acute encephalopathy in childhood

Mizuguchi

Ichiyama

Imataka

et al. 2021

Brain and Development

137

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“…The disorder is characterized by a prolonged febrile seizure, followed later by cluster of subsequent seizures and magnetic resonance imaging (MRI) abnormality noted on days 4 to 6, resulting in high incidence of neurological sequelae. 22…”

Section: Epidemiology and Pathophysiologymentioning

confidence: 99%

Simple Febrile Seizures: A Benign Phenomena?

Andrade¹

2019

J Pediatr Epilepsy

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Febrile seizures are one of the most common neurological causes of visits to the emergency room. This article is a review of the current literature concerning the evaluation and treatment of children with febrile seizures. Longitudinal prospective studies such as the FEBSTAT study (consequences of prolonged febrile seizures in childhood) have contributed to elucidate the long-term outcome of patients with prolonged febrile seizures. Neurogenetic research also demonstrated the role of genetic mutations (mainly voltage-gated ion channels) in the etiology of febrile seizures. Most febrile seizures are self-limited events with low risk of injury or evolution into status epilepticus or sudden death. However, the use of rectal diazepam as acute abortive treatment for febrile seizures lasting 5 minutes or longer has gained acceptance as a first-line home intervention. Most patients with febrile seizures do not require extensive investigations, but the treatment involves a customized plan. Efforts should be directed to educate caregivers about prognosis and management of potential recurrences. In selected cases, appropriate use of preventive antiseizure medication may be a consideration.

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“…Some studies have indicated that early interventions [therapeutic hypothermia ( 3 ), vitamin B1, vitamin B6, and L-carnitine administration ( 4 ), and dextromethorphan treatment ( 5 )] may improve the outcomes of AESD, and it is clinically important to distinguish AESD from FS in the early phase after the onset of initial convulsive seizure. Some patients with FS experience prolonged seizures and impaired consciousness for several hours.…”

Section: Introductionmentioning

confidence: 99%

Predicting the Onset of Acute Encephalopathy With Biphasic Seizures and Late Reduced Diffusion by Using Early Laboratory Data

et al. 2021

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Background: Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) often causes various neurological sequelae, necessitating early and objective differentiation of AESD from a febrile seizure (FS). Therefore, we developed a scoring system that predicts AESD onset using only early laboratory data.Methods: We selected patients with AESD or FS admitted to the Tottori University Hospital between November 2005 and September 2020 and collected laboratory data from onset to discharge in patients with FS and from onset to the second neurological events in patients with AESD.Results: We identified 18 patients with AESD and 181 patients with FS. In comparison with patients with FS, patients with AESD showed statistically significant increases in ammonia (NH3), blood sugar (BS), and serum creatinine (Cr) levels, and the white blood cell (WBC) count, and a significant decrease in pH at <3 h from onset. We set the cut-off values and adjusted the weight of each of these parameters based on data obtained <3 h from onset and proposed a scoring system for predicting AESD. This system showed 91% sensitivity and 94% specificity for distinguishing AESD from FS. These accuracies were only slightly improved by the addition of information related to consciousness and seizure duration (sensitivity, 91%; specificity, 96%).Conclusion: NH3, BS, and Cr levels, WBC count, and pH were significantly different between patients with AESD and patients with FS at <3 h from seizure onset. This scoring system using these data may enable the prediction of AESD onset for patients under sedation or without precise clinical information.

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Early administration of vitamins B1 and B6 and l-carnitine prevents a second attack of acute encephalopathy with biphasic seizures and late reduced diffusion: A case control study

Cited by 24 publications

References 14 publications

Guidelines for the diagnosis and treatment of acute encephalopathy in childhood

Guidelines for the diagnosis and treatment of acute encephalopathy in childhood

Simple Febrile Seizures: A Benign Phenomena?

Predicting the Onset of Acute Encephalopathy With Biphasic Seizures and Late Reduced Diffusion by Using Early Laboratory Data

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