Analysis of early predictive factors for developing acute encephalopathy with biphasic seizures and late reduced diffusion

Abstract

  Objective: Early differentiation of Acute encephalopathy with biphasic seizure and late reduced diffusion (AESD) from febrile status epilepticus (FSE) at the time of first seizure would be clinically valuable. In the current study, we examined a scoring system for predicting the onset of AESD immediately after first seizure. Methods: Subjects were patients diagnosed with FSE and AESD during the period from April 2011 to April 2017. Statistical analysis was performed on patients’ background, clinical course, and initial blood and cerebrospinal fluid findings immediately after first seizure. Using the multivariate analysis, we extracted the predictive factors for the onset of AESD, calculated the cutoff value and constructed a scoring system to predict the onset of AESD based on logistic analysis. Results: There were 55 patients in the FSE group and 28 patients in the AESD group. The multivariate analysis revealed four items as the predictive factors ; (1) the age of onset was 18 months or less, (2) the convulsion duration was 30 minutes or more, (3) Cr was 0.3mg/dL or more, and (4) AST was 42IU/L or more. When we used the cutoff values for the onset of AESD evaluated from these factors, sensitivity and specificity were 91.7% and 65.4%, respectively. Conclusions: Immediately after first seizure, by evaluating four items, it is possible to predict the onset of AESD without observing the state of consciousness.