Acute Necrotizing Encephalopathy in Korean Infants and Children: Imaging Findings and Diverse Clinical Outcome.
- Author:
Ji Hye KIM
1
;
In One KIM
;
Myung Kwan LIM
;
Man Soo PARK
;
Choong Gon CHOI
;
Hye Won KIM
;
Jee Eun KIM
;
Soo Jin CHOI
;
Young Hwan KOH
;
Dal Mo YANG
;
Sung Wook CHOO
;
Myung Jin CHUNG
;
Hye Kyung YOON
;
Hyun Woo GOO
;
Munhyang LEE
Author Information
- Publication Type:Original Article
- Keywords: Brain, encephalopathy; Infants and children, disease; Brain, MR
- MeSH: Brain/pathology; Child; Child, Preschool; Female; Humans; Infant; Korea; Leukoencephalitis, Acute Hemorrhagic/complications/*pathology; *Magnetic Resonance Imaging; Male; Prognosis; Retrospective Studies
- From:Korean Journal of Radiology 2004;5(3):171-177
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: The purpose of our study was to describe acute necrotizing encephalopathy in Korean infants and children, and we sought to evaluate the prognostic factors. MATERIALS AND METHODS: Acute necrotizing encephalopathy was diagnosed in 14 Korean infants and children. We retrospectively analyzed the neuroimaging findings including the follow-up changes. The clinical course of the disease was graded, and we evaluated prognostic factors including age, serum level of the aminotransferase, hemorrhage, and localized atrophy of the brain. RESULTS: This encephalopathy predominantly affected the bilateral thalami (n=14), pons (n=12), and midbrain (n=10) in a symmetrical pattern. Hemorrhage was observed in eight patients (57%). On the follow-up images (n=12), the brain lesions were reduced in extent for all patients, and generalized atrophy was seen in six patients. Localized tissue loss was observed in five patients and a complete resolution occurred for one patient. All the patients survived and two recovered completely; mild (n=6) to severe (n=6) neurological deficits persisted in the remaining 12 patients. The significant prognostic factors identified in this study were the presence of hemorrhage (p = 0.009) and localized atrophy (p = 0.015). CONCLUSION: Acute necrotizing encephalopathy in Korean patients showed the characteristic patterns of the post-infectious encephalopathy as described in the literature. The high survival rate and the relatively favorable clinical course observed for the present study suggest a more diverse spectrum of disease severity than was previously described. The presence of hemorrhage and localized tissue loss on MR images may suggest a poor prognosis.
