Short and long-term outcomes in children with suspected acute encephalopathy

Masahiro Nishiyama, Hiroaki Nagase, Tsukasa Tanaka, Kyoko Fujita, Mayumi Kusumoto, Shinsuke Kajihara, Yoshimichi Yamaguchi, Azusa Maruyama, Hiroki Takeda, Yoshiyuki Uetani, Kazumi Tomioka, Daisaku Toyoshima, Mariko Ikeda, Ichiro Morioka, Satoshi Takada, Kazumoto Iijima

Research output: Contribution to journalArticle

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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) 6 months to 15 years 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 12 months, 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.

Original languageEnglish
Pages (from-to)731-737
Number of pages7
JournalBrain and Development
Volume38
Issue number8
DOIs
Publication statusPublished - 01-09-2016

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Brain Diseases
Pediatrics
Brain
Persistent Vegetative State
Pediatric Intensive Care Units
Brain Death
Consciousness
Age of Onset
Seizures
Fever
Databases

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health
  • Developmental Neuroscience
  • Clinical Neurology

Cite this

Nishiyama, M., Nagase, H., Tanaka, T., Fujita, K., Kusumoto, M., Kajihara, S., ... Iijima, K. (2016). Short and long-term outcomes in children with suspected acute encephalopathy. Brain and Development, 38(8), 731-737. https://doi.org/10.1016/j.braindev.2016.02.011
Nishiyama, Masahiro ; Nagase, Hiroaki ; Tanaka, Tsukasa ; Fujita, Kyoko ; Kusumoto, Mayumi ; Kajihara, Shinsuke ; Yamaguchi, Yoshimichi ; Maruyama, Azusa ; Takeda, Hiroki ; Uetani, Yoshiyuki ; Tomioka, Kazumi ; Toyoshima, Daisaku ; Ikeda, Mariko ; Morioka, Ichiro ; Takada, Satoshi ; Iijima, Kazumoto. / Short and long-term outcomes in children with suspected acute encephalopathy. In: Brain and Development. 2016 ; Vol. 38, No. 8. pp. 731-737.
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Nishiyama, M, Nagase, H, Tanaka, T, Fujita, K, Kusumoto, M, Kajihara, S, Yamaguchi, Y, Maruyama, A, Takeda, H, Uetani, Y, Tomioka, K, Toyoshima, D, Ikeda, M, Morioka, I, Takada, S & Iijima, K 2016, 'Short and long-term outcomes in children with suspected acute encephalopathy', Brain and Development, vol. 38, no. 8, pp. 731-737. https://doi.org/10.1016/j.braindev.2016.02.011

Short and long-term outcomes in children with suspected acute encephalopathy. / Nishiyama, Masahiro; Nagase, Hiroaki; Tanaka, Tsukasa; Fujita, Kyoko; Kusumoto, Mayumi; Kajihara, Shinsuke; Yamaguchi, Yoshimichi; Maruyama, Azusa; Takeda, Hiroki; Uetani, Yoshiyuki; Tomioka, Kazumi; Toyoshima, Daisaku; Ikeda, Mariko; Morioka, Ichiro; Takada, Satoshi; Iijima, Kazumoto.

In: Brain and Development, Vol. 38, No. 8, 01.09.2016, p. 731-737.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Short and long-term outcomes in children with suspected acute encephalopathy

AU - Nishiyama, Masahiro

AU - Nagase, Hiroaki

AU - Tanaka, Tsukasa

AU - Fujita, Kyoko

AU - Kusumoto, Mayumi

AU - Kajihara, Shinsuke

AU - Yamaguchi, Yoshimichi

AU - Maruyama, Azusa

AU - Takeda, Hiroki

AU - Uetani, Yoshiyuki

AU - Tomioka, Kazumi

AU - Toyoshima, Daisaku

AU - Ikeda, Mariko

AU - Morioka, Ichiro

AU - Takada, Satoshi

AU - Iijima, Kazumoto

PY - 2016/9/1

Y1 - 2016/9/1

N2 - 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) 6 months to 15 years 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 12 months, 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.

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Nishiyama M, Nagase H, Tanaka T, Fujita K, Kusumoto M, Kajihara S et al. Short and long-term outcomes in children with suspected acute encephalopathy. Brain and Development. 2016 Sep 1;38(8):731-737. https://doi.org/10.1016/j.braindev.2016.02.011