Delirious behavior in children with acute necrotizing encephalopathy.
OBJECTIVE
To clarify the features of delirious behavior in patients with acute necrotizing encephalopathy.


METHODS
We retrospectively evaluated the clinical course of 38 children with acute necrotizing encephalopathy diagnosed on the basis of neuroradiological findings. The patients were divided into two groups according to the presence or absence of delirious behavior. We compared clinical features, laboratory data, neuroimaging findings, and outcome between those with and without delirious behavior. In patients with delirious behavior, chronological sequence of neurological symptoms and the characteristics of delirious behavior were investigated.


RESULTS
Delirious behavior was observed in 8 patients. Patient characteristics or most laboratory data on admission were not significantly different between those with and without delirious behavior. Brainstem lesions were more frequent in patients with delirious behavior than in those without. In contrast, lesions in lentiform nuclei, cerebral hemisphere, or cerebellum were relatively more frequent in patients without delirious behavior. It was the initial neurological symptom in 7 of 8 patients. Stupor and seizures were observed after delirious behavior in most patients.


CONCLUSIONS
Delirious behavior was not uncommon in children with acute necrotizing encephalopathy. Brainstem lesions may be related to the development of delirious behavior of children with acute necrotizing encephalopathy.
Department of Pediatrics, Juntendo University School of Medicine, Tokyo, Japan. okumura@med.juntendo.ac.jp
Akihisa
A
Okumura
Masashi
M
Mizuguchi
Hideo
H
Aiba
Takuya
T
Tanabe
Takeshi
T
Tsuji
Ayako
A
Ohno
D001933:Brain Stem / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003693:Delirium / Q000209:etiology* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D004684:Leukoencephalitis, Acute Hemorrhagic / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies