Post-encephalopathic epilepsy (PEE) is a serious complication of acute encephalopathy syndromes, and is more frequent in patients with acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) than in children with acute encephalopathy. However, a risk factor analysis using laboratory findings in the acute phase of AESD has not yet been performed. Therefore, the present study examined risk factors of AESD-related PEE using laboratory parameters in the acute phase of AESD. We retrospectively screened 27 pediatric patients with AESD for inclusion, and enrolled 20 (“the PEE group”, n = 6; “the non-PEE group”, n = 14) according to inclusion criteria. The incidence of AESD-related PEE was 30 %, and the median duration from the onset of AESD to the development of PEE was 2.5 months (range, 1–32). The most common types of seizures were focal seizures, epileptic spasms, and startle seizures: 4 out of 6 patients (66.7 %) had intractable epilepsy. The median values of alanine aminotransferase (ALT) in the 1st and 2nd seizure phases of AESD and aspartate aminotransferase (AST) in the 2nd seizure phase were significantly higher in the PEE group than in the non-PEE group ( < 0.01). This is the first study to report higher serum levels of ALT and AST at the onset of AESD as risk factors for AESD-related PEE. We also provided a detailed description on the clinical characteristics on AESD-related PEE, which are consistent with previous findings.

中文翻译：

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伴有双相性癫痫发作和晚期扩散减少的急性脑病患者发生脑病后癫痫的危险因素

脑病后癫痫（PEE）是急性脑病综合征的严重并发症，与急性脑病儿童相比，双相性癫痫发作和晚期扩散减少（AESD）的急性脑病患者更常见。然而，尚未利用 AESD 急性期的实验室结果进行危险因素分析。因此，本研究利用 AESD 急性期的实验室参数检查了 AESD 相关 PEE 的危险因素。我们回顾性筛选了 27 名 AESD 儿童患者，根据纳入标准纳入了 20 名患者（“PEE 组”，n = 6；“非 PEE 组”，n = 14）。AESD 相关 PEE 的发生率为 30%，从 AESD 发生到发生 PEE 的中位持续时间为 2.5 个月（范围：1-32）。最常见的癫痫发作类型是局灶性癫痫发作、癫痫痉挛和惊恐发作：6 名患者中有 4 名 (66.7%) 患有难治性癫痫。PEE 组 AESD 第 1 和第 2 发作期丙氨酸转氨酶 (ALT) 以及第 2 发作期天冬氨酸转氨酶 (AST) 中位值显着高于非 PEE 组 ( < 0.01)。这是第一项报告 AESD 发生时血清 ALT 和 AST 水平升高是 AESD 相关 PEE 危险因素的研究。我们还详细描述了 AESD 相关 PEE 的临床特征，这与之前的发现一致。