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ID 59904
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Miyahara, Hiroyuki Department of Pediatrics, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences ORCID Kaken ID
Akiyama, Tomoyuki Department of Child Neurology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences Kaken ID researchmap
Waki, Kenji Department of Pediatrics, Kurashiki Central Hospital
Arakaki, Yoshio Department of Pediatrics, Kurashiki Central Hospital
Abstract
Background
Nonepileptic twilight state with convulsive manifestations (NETC) is a nonepileptic state following a febrile seizure (FS), which may be misdiagnosed as a prolonged seizure and result in overtreatment. We aimed to describe clinical manifestations of NETC and to determine characteristics that are helpful to distinguish NETC from other pathological conditions.
Methods
We conducted a retrospective chart review from January 2010 to December 2016 and selected the patients who presented with symptoms resembling status epilepticus with fever and a confirmed diagnosis using an electroencephalogram (EEG). We compared the NETC clinical features and venous blood gas analysis results with those of other conditions that mimic NETC. We also compared the characteristics of NETC with past reports.
Results
Our NETC patients presented with short durations of the preceding generalized convulsions followed by tonic posturing, closed eyes, no cyanosis, responsiveness to painful stimulation, and no accumulation of CO2 in the venous blood gas. Most of these characteristics were consistent with past reports. Prolonged FS or acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) showed several of these features, but all the characteristics were not consistent with our study.
Conclusions
Prolonged FS and AESD need to be differentiated from NETC, and close clinical observation makes it possible to partially distinguish NETC from the other conditions. EEG is recommended for patients with symptoms that are inconsistent with these features.
Keywords
Prolonged febrile seizure
Acute encephalopathy with biphasic seizures and late reduced diffusion
Venous blood gas analysis
Electroencephalogram
Clinical characteristics
Venous blood gas
Published Date
2018-01-14
Publication Title
Brain and Development
Volume
volume40
Issue
issue9
Publisher
Elsevier
Start Page
781
End Page
785
ISSN
0387-7604
NCID
AA00111153
Content Type
Journal Article
language
英語
OAI-PMH Set
岡山大学
Copyright Holders
© 2018 The Japanese Society of Child Neurology
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isVersionOf https://doi.org/10.1016/j.braindev.2018.05.014
License
https://creativecommons.org/licenses/by-nc-nd/4.0/