BACKGROUND Acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is characterized by biphasic seizures and impaired consciousness. The efficacy of hypothermia/normothermia therapy in patients with AESD has rarely been reported on. METHODS We enrolled 15 patients with AESD admitted to Yamaguchi University Hospital and Yamaguchi-ken Saiseikai Shimonoseki General Hospital between 2005 and 2019 and retrospectively evaluated the long-term efficacy of hypothermia therapy compared to that of non-hypothermia therapy. We compared the long-term sequelae of patients with AESD treated with or without hypothermia therapy. We used the Pediatric Cerebral Performance Category (PCPC) scale and intelligence tests including the Wechsler Intelligence Scale for Children, Tanaka-Binet Intelligence Scale, and Enjoji Infantile Developmental Scale to evaluate neurological sequelae and mental disability. The preventive effect of hypothermia therapy was assessed based on the development of post-encephalopathic epilepsy (PEE). RESULTS There was no significant between-group difference in the PCPC score (p = 0.53). The subjects with severe mental disability in the hypothermia therapy group were 0 (0%), while those in the non-hypothermia group were 2 (29%); however, the difference was not significant. Notably, there were no patients with onset of PEE in the hypothermia therapy group, while there were 4 (57.1%) in the non-hypothermia group (p = 0.03). CONCLUSIONS Our study suggests that hypothermia therapy may be effective in the long-term sequelae of AESD in terms of preventing the development of PEE. We propose that hypothermia therapy could contribute to improve the quality of life in these patients by preventing the subsequent onset of PEE.

中文翻译：

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低温治疗对双相发作和迟发弥散减弱的急性脑病患者的疗效

背景 伴有双相发作和迟发弥散减慢 (AESD) 的急性脑病的特征是双相发作和意识障碍。低温/常温治疗对 AESD 患者的疗效鲜有报道。方法 我们纳入了 2005 年至 2019 年间在山口大学医院和山口县 Saiseikai Shimonoseki 综合医院收治的 15 名 AESD 患者，并回顾性评估了低温疗法与非低温疗法相比的长期疗效。我们比较了接受或不接受低温治疗的 AESD 患者的长期后遗症。我们使用了小儿脑表现类别 (PCPC) 量表和智力测试，包括 Wechsler 儿童智力量表、Tanaka-Binet 智力量表、和 Enjoji 婴儿发育量表来评估神经系统后遗症和精神残疾。根据脑病后癫痫 (PEE) 的发展情况评估低温治疗的预防效果。结果 PCPC 评分无显着组间差异（p = 0.53）。低温治疗组严重精神障碍者为0例（0%），非低温治疗组为2例（29%）；然而，差异并不显着。值得注意的是，低温治疗组没有发生 PEE 的患者，而非低温治疗组有 4 名患者（57.1%）（p = 0.03）。结论 我们的研究表明，低温治疗可能对预防 PEE 发展的 AESD 长期后遗症有效。