title: A case of acute encephalopathy with biphasic seizures and late reduced diffusion: Utility of arterial spin labeling sequence.
abstract: A 1-year-old boy was admitted because of febrile status epilepticus (FSE). A secondary cluster of seizures was seen on day 5 after onset, and the patient eventually displayed developmental delay. Conventional magnetic resonance imaging (MRI) showed no abnormal findings on day 1 after onset, but showed reduced diffusion in the subcortical regions of bilateral frontal lobes on day 5 after onset. Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) was diagnosed. Arterial spin labeling (ASL) revealed reduced cerebral blood flow (CBF) in bilateral frontal lobes on day 1 after onset and showed increased CBF in the corresponding region in the subacute phase. Outcomes after prolonged febrile seizures are usually good, but mental deficit and/or epilepsy often remain in AESD. Discriminating between these syndromes is difficult, because no useful biomarkers have been identified. Reduced CBF in bilateral frontal lobes was observed on ASL on day 1 of FSE in the present case, and this finding may be predictive of developing AESD.
authors.affiliation: Division of Radiology, Department of Pathophysiological Therapeutic Science, Faculty of Medicine, Tottori University, Japan. Electronic address: keita98_1_7@hotmail.co.jp.
authors.forename: Keita
authors.initials: K
authors.lastname: Kuya
authors.affiliation: Division of Radiology, Department of Pathophysiological Therapeutic Science, Faculty of Medicine, Tottori University, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Fujii
authors.affiliation: Division of Radiology, Department of Pathophysiological Therapeutic Science, Faculty of Medicine, Tottori University, Japan.
authors.forename: Fuminori
authors.initials: F
authors.lastname: Miyoshi
authors.affiliation: Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Japan.
authors.forename: Koyo
authors.initials: K
authors.lastname: Ohno
authors.affiliation: Division of Radiology, Department of Pathophysiological Therapeutic Science, Faculty of Medicine, Tottori University, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Shinohara
authors.affiliation: Division of Child Neurology, Institute of Neurological Sciences, Faculty of Medicine, Tottori University, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Maegaki
authors.affiliation: Division of Radiology, Department of Pathophysiological Therapeutic Science, Faculty of Medicine, Tottori University, Japan.
authors.forename: Toshihide
authors.initials: T
authors.lastname: Ogawa
mesh_terms: D000071072:Acute Febrile Encephalopathy / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology; D002658:Developmental Disabilities / Q000000981:diagnostic imaging / Q000209:etiology; D003937:Diagnosis, Differential; D018450:Disease Progression; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000000981:diagnostic imaging* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D003294:Seizures, Febrile / Q000000981:diagnostic imaging* / Q000503:physiopathology
keywords: Acute encephalopathy with biphasic seizures and late reduced diffusion; Arterial spin labeling sequence; Febrile status epilepticus; Magnetic resonance imaging