Diagnostic and prognostic factors for acute encephalopathy.
BACKGROUND
Acute encephalopathy has the possibility of sequelae. While early treatment is required to prevent the development of sequelae, differential diagnosis is of the utmost priority. The aim of this study was therefore to identify parameters that can facilitate early diagnosis and prediction of outcome of acute encephalopathy.


METHODS
We reviewed the medical charts of inpatients from 2005 to 2011 and identified 33 patients with febrile status epilepticus. Subjects were classified into an acute encephalopathy group (n = 20) and a febrile convulsion group (n = 13), and the parameters serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), ammonia (NH3 ), cerebrospinal fluid (CSF) tau protein, and CSF interleukin-6 compared between them. Furthermore, the relationship between each parameter and prognosis was investigated in the encephalopathy group.


RESULTS
Significant differences in serum AST, ALT, and LDH were observed between the febrile convulsion and acute encephalopathy group. Moreover, a significant difference in serum LDH was noted between the patients with and without developmental regression at the time of hospital discharge in the encephalopathy group. In particular, CSF tau protein was found to be highly likely to indicate progress, with CSF tau protein >1000 pg/dL associated with poor prognosis leading to developmental regression.


CONCLUSION
Serum AST, ALT and LDH may be related to early diagnosis and prognosis, and should be carefully investigated in patients with encephalopathy. CSF tau protein could also be used as an indicator of poor prognosis in acute encephalopathy.
['Motojima|Yukiko|Y|', 'Nagura|Michiaki|M|', 'Asano|Yoshitaka|Y|', 'Arakawa|Hiroshi|H|', 'Takada|Eiko|E|', 'Sakurai|Yoshio|Y|', 'Moriwaki|Koichi|K|', 'Tamura|Masanori|M|']
D000208:Acute Disease D000410:Alanine Transaminase D001219:Aspartate Aminotransferases D015415:Biomarkers D001927:Brain Diseases D002648:Child D002675:Child, Preschool D003937:Diagnosis, Differential D005260:Female D006801:Humans D007223:Infant D015850:Interleukin-6 D008297:Male D011379:Prognosis D012189:Retrospective Studies D012307:Risk Factors D003294:Seizures, Febrile D016875:tau Proteins
acute encephalopathy diagnosis tau protein prognosis pediatrics