title: Short and long-term outcomes in children with suspected acute encephalopathy.
abstract: BACKGROUND
  The time-dependent changes that occur in children after acute encephalopathy are not clearly understood. Therefore, we assessed changes in brain function after suspected acute encephalopathy over time.
  
  
  METHODS
  We created a database of children admitted to the pediatric intensive care unit at Kobe Children's Hospital because of convulsions or impaired consciousness with fever between 2002 and 2013. Clinical courses and outcomes were reviewed and patients who met the following criteria were included in the study: (1) 6months to 15years of age, (2) no neurological abnormality before onset, (3) treated for suspected acute encephalopathy, and (4) followed after 1 (0-2) month and 12 (10-17) months of onset. Outcomes were assessed using the Pediatric Cerebral Performance Category (PCPC) scale, with a score of 1 representing normal performance; 2, mild disability; 3, moderate disability; 4, severe disability; 5, vegetative state; and 6, brain death.
  
  
  RESULTS
  A total of 78 children (32 male) with a median (range) age at onset of 20 (6-172) months were enrolled. Fifty-one cases scored 1 on the PCPC, 13 scored 2, three scored 3, five scored 4, one scored 5, and five cases scored 6 at discharge. Whereas seven of the 13 cases that scored a 2 on the PCPC recovered normal brain function after 12months, none of the nine cases that scored a 3-5 on the PCPC recovered normal function.
  
  
  CONCLUSIONS
  Our findings suggest moderate to severe disability caused by acute encephalopathy had lasting consequences on brain function, whereas mild disability might result in improved function.
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan; Department of Neurology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan. Electronic address: nishiyan0203@yahoo.co.jp.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Nishiyama
authors.affiliation: Department of Neurology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagase
authors.affiliation: Department of Neurology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Tanaka
authors.affiliation: Department of Neurology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Kyoko
authors.initials: K
authors.lastname: Fujita
authors.affiliation: Department of Emergency and Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Mayumi
authors.initials: M
authors.lastname: Kusumoto
authors.affiliation: Department of Emergency and Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Kajihara
authors.affiliation: Department of Emergency and Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Yoshimichi
authors.initials: Y
authors.lastname: Yamaguchi
authors.affiliation: Department of Neurology, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Azusa
authors.initials: A
authors.lastname: Maruyama
authors.affiliation: Department of Emergency and Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Takeda
authors.affiliation: Department of Emergency and Critical Care Medicine, Hyogo Prefectural Kobe Children's Hospital, Kobe, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Uetani
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Tomioka
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Daisaku
authors.initials: D
authors.lastname: Toyoshima
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Mariko
authors.initials: M
authors.lastname: Taniguchi-Ikeda
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Morioka
authors.affiliation: Kobe University Graduate School of Health Science, Kobe, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takada
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Kazumoto
authors.initials: K
authors.lastname: Iijima
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D001927:Brain Diseases / Q000453:epidemiology* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D004185:Disability Evaluation; D018450:Disease Progression; D005260:Female; D006776:Hospitals, Pediatric; D006801:Humans; D015278:Intensive Care Units, Pediatric; D007564:Japan; D008297:Male; D012720:Severity of Illness Index; D013997:Time Factors
keywords: Acute encephalopathy; Children; Outcome; PCPC; Sequelae; Status epilepticus