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Acute febrile encephalopathy and seizures in children with diffusion restriction lesions on magnetic resonance imaging brain: A case series


 Department of Pediatrics, Bharati Vidyapeeth Medical College and Hospital, Pune, Maharashtra, India

Correspondence Address:
Bhakti Sarangi,
3rd Floor, Department of Pediatrics, Bharati Vidyapeeth Medical College and Hospital, Pune-Satara Road, Katraj-Dhankawadi, Pune - 411 043
India
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/JPCC.JPCC_132_20

Over the last decade, several entities within the spectrum of acute febrile encephalopathy (AFE) including acute disseminated encephalomyelitis, acute necrotizing encephalitis, fever-induced refractory epilepsy syndrome, clinically mild encephalopathy with reversible splenial lesion, and autoimmune encephalitis have been recognized, all of which now have reasonably well-established clinicoradiological diagnostic criteria and therapeutic options. This case series highlights the clinical profile and outcome of seven children with the lesser-known entity of AFE with seizures and white matter diffusion restriction lesions on magnetic resonance imaging. All children had a history of acute onset fever, altered sensorium, and refractory seizures requiring multiple antiepileptic drugs and presented in shock requiring multiple organ support. All had extensive, diffusion-restricted lesions involving white matter. The infectious trigger was identified as influenza A (H3N2) in case 1, dengue virus in cases 2 and 6, and influenza B in case 4. Five children survived, each of whom had significant neurological sequelae.


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    -  Kumar S
    -  Reddy VS
    -  Sarangi B
    -  Walimbe A
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