title: Thalamic lesions in acute encephalopathy with biphasic seizures and late reduced diffusion.
abstract: BACKGROUND
  We aimed to assess the characteristics of thalamic lesions in children with acute encephalopathy with biphasic seizures and late reduced diffusion.
  
  
  METHODS
  Using the Tokai Pediatric Neurology Society database, we identified and enrolled 18 children with acute encephalopathy with biphasic seizures and late reduced diffusion from 2008 to 2010. Using diffusion-weighted images, we identified patients with thalamic lesions and compared their clinical factors with those of patients without thalamic lesions. We analyzed the time sequence of thalamic, sucortical, and cortical lesions. To study the topography of thalamic lesions, we divided the thalamus into five sections: anterior, medial, anterolateral, posterolateral, and posterior. Subsequently, we analyzed the relationship between the topography of thalamic lesions and the presence of central-sparing.
  
  
  RESULTS
  Seven children presented with symmetrical thalamic lesions associated with bilateral subcortical or cortical lesions. No statistical difference in the clinical features was observed between individuals with and without thalamic lesions. These lesions were observed only when subcortical or cortical lesions were present. In 5 children, thalamic lesions were present in bilateral anterior or anterolateral sections and were associated with subcortical or cortical lesions in bilateral frontal lobes with central-sparing. In the other two children, thalamic lesions were extensive and accompanied by diffuse subcortical and cortical lesions without central-sparing.
  
  
  CONCLUSIONS
  Thalamic lesions in patients with acute encephalopathy with biphasic seizures and late reduced diffusion involve the anterior sections. The thalamocortical network may play a role in development of thalamic lesions in patients with acute encephalopathy with biphasic seizures and late reduced diffusion.
authors.affiliation: Department of Pediatric Neurology, Central Hospital, Aichi Human Service Center, Kasugai, Aichi, Japan. Electronic address: hayashi@aichi-colony.jp.
authors.forename: Naoko
authors.initials: N
authors.lastname: Kurahashi
authors.affiliation: Department of Pediatrics, Okazaki City Hospital, Okazaki, Aichi, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Tsuji
authors.affiliation: Department of Pediatrics, Okazaki City Hospital, Okazaki, Aichi, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Kato
authors.affiliation: Department of Pediatric Neurology, Central Hospital, Aichi Human Service Center, Kasugai, Aichi, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Ogaya
authors.affiliation: Department of Pediatric Neurology, Central Hospital, Aichi Human Service Center, Kasugai, Aichi, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Umemura
authors.affiliation: Department of Pediatric Neurology, Central Hospital, Aichi Human Service Center, Kasugai, Aichi, Japan.
authors.forename: Keitaro
authors.initials: K
authors.lastname: Yamada
authors.affiliation: Department of Pediatric Neurology, Central Hospital, Aichi Human Service Center, Kasugai, Aichi, Japan; Department of Pediatrics, Aichi Medical University, Nagakute, Aichi, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kurahashi
authors.affiliation: Department of Pediatric Neurology, Central Hospital, Aichi Human Service Center, Kasugai, Aichi, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Maruyama
authors.affiliation: Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Takeuchi
authors.affiliation: Department of Pediatrics, Anjo Kosei Hospital, Anjo, Aichi, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Kubota
authors.affiliation: Department of Pediatrics and Neonatology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Saitoh
authors.affiliation: Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Natsume
authors.affiliation: Department of Pediatrics, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan; Department of Pediatrics, Aichi Medical University, Nagakute, Aichi, Japan.
authors.forename: Akihisa
authors.initials: A
authors.lastname: Okumura
mesh_terms: D000367:Age Factors; D001927:Brain Diseases / Q000150:complications* / Q000473:pathology*; D001931:Brain Mapping; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012640:Seizures / Q000209:etiology*; D018709:Statistics, Nonparametric; D013788:Thalamus / Q000473:pathology*
keywords: acute encephalopathy; acute encephalopathy with biphasic seizures and late reduced diffusion; diffusion weighted image; thalamic lesion; thalamocortical system