ヤスカワ　クミ   安川　久美    所属   医学部 医学科（附属八千代医療センター）    職種   准教授
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	A new infectious encephalopathy syndrome, clinically mild encephalopathy associated with excitotoxicity (MEEX).
掲載誌名	正式名：Journal of the neurological sciences 略　 称：J Neurol Sci ISSNコード：18785883/0022510X
掲載区分	国外
巻・号・頁	380,pp.27-30
著者・共著者	Hirai Nozomi, Yoshimaru Daisuke, Moriyama Yoko, Yasukawa Kumi, Takanashi Jun-Ichi
発行年月	2017/09
概要	Acute infectious encephalopathy is often observed in children in East Asia including Japan. More than 40% of the patients remain unclassified into specific syndromes. To investigate the underlying pathomechanisms in those with unclassified encephalopathy, we evaluated brain metabolism by MR spectroscopy. Among seven patients with acute encephalopathy admitted to our hospital from June 2016 to May 2017, three were classified into acute encephalopathy with biphasic seizures and late reduced diffusion (AESD). The other four showed consciousness disturbance lasting more than three days with no parenchymal lesion visible on MRI, which led to a diagnosis of unclassified encephalopathy. MR spectroscopy in these four patients, however, revealed an increase of glutamine with a normal N-acetyl aspartate level on days 5 to 8, which had normalized by follow-up studies on days 11 to 16. The four patients clinically recovered completely. Among 27 patients with encephalopathy, including the present seven patients, admitted to our hospital from January 2015 to March 2017, seven (26%) were classified into this type, which we propose is a new encephalopathy syndrome, clinically mild encephalopathy associated with excitotoxicity (MEEX). MEEX is the second most common subtype, following AESD (30%). This study suggests that excitotoxicity may be a common underlying pathomechanism of acute infectious encephalopathy, and prompt astrocytic neuroprotection from excitotoxicity may prevent progression of MEEX into AESD.
DOI	10.1016/j.jns.2017.06.045
PMID	28870583