The Correlation Between Long-Lasting Serum Lactate And Brain Mri Abnormality In Children With Status Epilepticus

Abstract

Background: Serum lactate was a biomarker implemented to estimate the prognosis in children suffered from status epilepticus (SE). Brain neuroimaging may demonstrate the site area, range of neuronal impairment and ischemic injury. This study aims to evaluate the correlation between long-lasting serum lactate with brain imaging abnormality reflected on Magnetic Resonance Imaging (MRI) in children suffered from SE. Method: This prospective analytical research was conducted from June-November 2018 in children with SE. Serum lactate were collected on 24 hours following SE, and brain MRI was carried out within a period of 7-14 days after SE terminated. Abnormal MRI was categorized as Hypoxic Ischemic Encephalopathy (HIE) grade I to III. Statistical analysis with Kruskal Wallis was applied to calculate the details. Results: Forty two SE subjects were enrolled, 85.7% boys, with a mean age of 59.29 months and mostly with the diagnosis of encephalitis (47.6%). Elevated serum lactate levels were found in 71.4% of patients and about 47.8% had abnormal MRI images in the form of HIE Grade I. Mean serum lactate level in HIE grade I, II, III was 1.69 mmol/L, 3.32 mmol/L, 3.48 mmol/L respectively. Two patients were death and 28.6% had a life with neurological deficit. There was a significant correlation (p=0.021) between long-lasting serum lactate level and abnormal brain MRI. Conclusion: In children suffered from SE, HIE grade I is the most neuroimaging pattern obtained, and long-lasting serum lactate was considered to correlate with abnormal brain MRI.

Factors Associated with Neuroimaging Abnormalities in Children with Afebrile Seizure: A Retrospective Multicenter Study

“…27,28 Gunawan et al recently reported a correlation between serum lactate level and abnormal brain MRI findings in children with status epilepticus. 29 Lactate elevation and adenosine triphosphate depletion during the early phase of seizures are related to hypermetabolic neuronal damage. 29 Similarly, lactic acid was a strong associated factor of neuroimaging abnormalities in our pediatric patients experiencing their first afebrile seizure.…”

“…29 Lactate elevation and adenosine triphosphate depletion during the early phase of seizures are related to hypermetabolic neuronal damage. 29 Similarly, lactic acid was a strong associated factor of neuroimaging abnormalities in our pediatric patients experiencing their first afebrile seizure. In addition, Shapiro et al reported that unbound and free unconjugated bilirubin can selectively damage the central nervous system in the developing brain.…”