Acute encephalopathy with refractory status epilepticus: bilateral mesial temporal and claustral lesions, associated with a peripheral marker of oxidative DNA damage.
We describe a 12-year-old girl, who had been medicated with theophylline for bronchial asthma and developed acute encephalopathy with refractory status epilepticus, showing bilateral mesial temporal and claustral lesions, which were evident on fluid-attenuated inversion recovery images, obtained with 1.5 T magnetic resonance imaging. To date, oxidative stress has been implicated in aging or various disorders, including inflammatory or degenerative neurological disorders. One of the oxidative stress markers, 8-hydroxydeoxyguanosine, was increased in our patient's cerebro-spinal fluid, plasma and urine. We speculate that augmented oxidative stress was associated with refractory status epilepticus in our patient, accompanying bilateral mesial temporal, claustral lesions and severe neuronal damage. Serial measurements of oxidative stress markers in acute encephalitis, encephalopathy, or status epilepticus could clarify the relationships between acute brain damage and free radicals.
Shiihara
Takashi
T
Department of Pediatrics, Yamagata University School of Medicine, 2-2-2 Iida-nishi, Yamagata 990-9585, Japan. shiihara-ind@umin.net
Kato
Mitsuhiro
M
Ichiyama
Takashi
T
Takahashi
Yukitoshi
Y
Tanuma
Naoyuki
N
Miyata
Rie
R
Hayasaka
Kiyoshi
K
D000080242:8-Hydroxy-2'-Deoxyguanosine; D000208:Acute Disease; D000927:Anticonvulsants / Q000627:therapeutic use; D001284:Atrophy / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D001479:Basal Ganglia / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D015415:Biomarkers / Q000097:blood / Q000134:cerebrospinal fluid / Q000652:urine; D001921:Brain / Q000378:metabolism / Q000473:pathology* / Q000503:physiopathology; D001928:Brain Diseases, Metabolic / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D001993:Bronchodilator Agents / Q000009:adverse effects; D002648:Child; D015897:Comorbidity; D004249:DNA Damage / Q000502:physiology*; D003849:Deoxyguanosine / Q000031:analogs & derivatives* / Q000097:blood / Q000134:cerebrospinal fluid / Q000652:urine; D005260:Female; D005609:Free Radicals / Q000097:blood / Q000134:cerebrospinal fluid / Q000652:urine; D006801:Humans; D008279:Magnetic Resonance Imaging; D018384:Oxidative Stress / Q000502:physiology*; D013226:Status Epilepticus / Q000175:diagnosis / Q000378:metabolism / Q000503:physiopathology*; D013702:Temporal Lobe / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology; D013806:Theophylline / Q000009:adverse effects; D016896:Treatment Outcome; D015854:Up-Regulation / Q000502:physiology
D000927:Anticonvulsants; D015415:Biomarkers; D001993:Bronchodilator Agents; D005609:Free Radicals; D000080242:8-Hydroxy-2'-Deoxyguanosine; D013806:Theophylline; D003849:Deoxyguanosine