Acute encephalitis with refractory, repetitive partial seizures (AERRPS): a peculiar form of childhood encephalitis.
OBJECTIVE
We conducted a nationwide multicenter study in Japan to elucidate the clinical and laboratory characteristics of acute encephalitis with refractory, repetitive partial seizures (AERRPS).


METHODS
Clinical and laboratory features, treatment, and outcome were assessed using a structured questionnaire.


RESULTS
Twenty-nine children were enrolled in the study. Refractory and repetitive partial seizures accompanied by fever were the cardinal clinical features. Partial seizures consisted principally of eye deviation or facial twitching, being periodically repeated during the acute phase. These seizures were refractory to conventional anticonvulsants and were only suppressed by high-dose intravenous barbiturate administration. Rhythmic activities on electroencephalography and non-specific cerebral atrophy on neuroimaging were common. Serum or cerebrospinal antibodies against GluRepsilon2 were positive in six patients. General prognosis was unfavorable due to intractable epilepsy and cognitive deficits.


CONCLUSIONS
Based on the peculiar and homogenous features, AERRPS can be regarded as a distinct clinical entity.
Sakuma
H
H
Department of Child Neurology, National Center Hospital for Mental, Nervous and Muscular Disorders, Tokyo, Japan. sakumah@ncnp.go.jp <sakumah@ncnp.go.jp>
Awaya
Y
Y
Shiomi
M
M
Yamanouchi
H
H
Takahashi
Y
Y
Saito
Y
Y
Sugai
K
K
Sasaki
M
M
D000208:Acute Disease; D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D001284:Atrophy; D001463:Barbiturates / Q000627:therapeutic use; D054022:Cerebrum / Q000473:pathology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology; D004569:Electroencephalography; D004660:Encephalitis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology* / Q000503:physiopathology*; D004828:Epilepsies, Partial / Q000150:complications / Q000503:physiopathology*; D005260:Female; D005334:Fever / Q000150:complications; D006801:Humans; D007223:Infant; D008297:Male; D016194:Receptors, N-Methyl-D-Aspartate / Q000378:metabolism; D011795:Surveys and Questionnaires
D000927:Anticonvulsants; D001463:Barbiturates; C121001:NR2B NMDA receptor; D016194:Receptors, N-Methyl-D-Aspartate; C032232:barbituric acid