Efficacy of cEEG and hepatic function to diagnose early acute encephalopathy.

Abstract

Early treatment may improve prognosis of acute encephalopathy. However, methods for the early diagnosis have not yet been established. In this paper, we examined methods for the early diagnosis. We extracted patients with febrile status epilepticus from the electronic medical records in our department between March 2016 and April 2021. Among these, 79 patients who underwent continuous electroencephalography (cEEG) were included in this study. Patients who exhibited psychomotor retardation or abnormal brain magnetic resonance imaging (MRI) findings were assigned to the acute encephalopathy group (Group E: n=20), and the remaining patients were the control group (Group C: n=59). The following tests on admission were compared retrospectively between these two groups: cEEG, serum hepatic function tests, and blood coagulation tests. The percentage of patients who exhibited high-amplitude slow waves or flat waves on cEEG at the time of admission was statistically significantly higher in Group E than in Group C (p < 0.01). Moreover, the percentage of patients whose high-amplitude slow waves or flat brain waves on admission disappeared within six hours after an initial episode of convulsion was statistically significantly lower in Group E than in Group C (p < 0.01). Furthermore, all the items in the coagulation and in the hepatic function test were statistically significantly different in Group E than those in Group C (p < 0.05). These results showed that cEEG adding to hepatic function and coagulation tests may be useful for the differential diagnosis of acute encephalopathy.