A Case of Mild Influenza-Associated Encephalopathy with Biphasic Seizures and Late Reduced Diffusion in Korea
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Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is one form of encephalopathy that has a biphasic clinical course and a typical magnetic resonance imaging (MRI) finding of reduced diffusion in the frontal or frontoparietal subcortical white matter, with sparing of the perirolandic region. There have been no previous reports of influenza-associated AESD in Korea, while approximately 20 cases per annum have been reported in Japan. We report a 24month- old Korean female with a clinically, radiologically diagnosed mild form of AESD associated with influenza A. The patient had a complex partial seizure on the second day of fever, followed by a cluster of brief seizures on the fifth day of viral febrile disease. MRI showed diffusion restrictions on the subcortical white matter and cortex of both frontoparietal lobes. Influenza A was proven after her temperature had fallen. Her clinical symptoms improved gradually without using oseltamivir, and no other neurologic sequelae remained. This case report is the first reported mild form of influenza-associated AESD in Korea. The ethnicity and regionality of influenza-associated encephalopathy should be widely studied.
Abstract
Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is one form of encephalopathy that has a biphasic clinical course and a typical magnetic resonance imaging (MRI) finding of reduced diffusion in the frontal or frontoparietal subcortical white matter, with sparing of the perirolandic region. There have been no previous reports of influenza-associated AESD in Korea, while approximately 20 cases per annum have been reported in Japan. We report a 24month- old Korean female with a clinically, radiologically diagnosed mild form of AESD associated with influenza A. The patient had a complex partial seizure on the second day of fever, followed by a cluster of brief seizures on the fifth day of viral febrile disease. MRI showed diffusion restrictions on the subcortical white matter and cortex of both frontoparietal lobes. Influenza A was proven after her temperature had fallen. Her clinical symptoms improved gradually without using oseltamivir, and no other neurologic sequelae remained. This case report is the first reported mild form of influenza-associated AESD in Korea. The ethnicity and regionality of influenza-associated encephalopathy should be widely studied.
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