[Neuroradiological findings in the acute stage of influenza encephalopathy].
Influenza encephalopathy(IE) is characterized by its high incidence in Japanese children between 1 year and 5 years of age, its onset in the first or the second day of illness and its high mortality (15-30%) and morbidity (25-40%). We proposed the classification of IE with poor prognosis from the neuroradiological findings. Four types of encephalopathy seem to be differentiated from each other, 1. acute necrotising encephalopathy(ANE) type, 2. hemorrhagic shock and encephalopathy syndrome (HSES) type, 3. acute brain swelling(ABS) type, 4. acute encephalopathy with febrile convulsive status epilepticus (AEFCSE) type. The notable radiological features are thalamic lesions in ANE, diffuse cerebral cortical cytotoxic edema in HSES, reversible cerebral swelling in ABS which sometimes reaches lethal brain herniation, and localised cerebral edema which is called as "lobar edema" because its extent seems to be equivalent to cerebral lobes. "Lobar edema" is developed about four days after status epilepticus simultaneously with the onset of repetitious focal seizure and neurological deterioration. The radiological changes in the early phase of IE are described in each types. In conclusion IE is a constellation of different types of encephalopathy although a further research of encephalopathy is urgently needed.
Shiomi
Masashi
M
Department of Pediatric Emergency Medicine, Osaka City General Hospital.
Togawa
Masao
M
Ishikawa
Junichi
J
Yamamuro
Miho
M
D000208:Acute Disease; D001921:Brain / Q000000981:diagnostic imaging; D001927:Brain Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D011859:Radiography; D013226:Status Epilepticus