From Crisis to Recovery: A Case Report on Acute Necrotizing Encephalopathy of Childhood

Case DesCriptionA 6-year 7-month-old male child who was developmentally normal and immunized for age was brought to our medical facility with a 3-day history of fever, nonproductive cough, and cold.He also introDuCtion Acute necrotizing encephalopathy of childhood (ANEC) is an uncommon but severe type of encephalopathy commonly occurring in Japan, Taiwan, and Korea. 1 It is marked by significant neurological complications that typically arise in previously healthy infants and young children after exposure to a potential viral or bacterial infection. 2Though the disease etiology and pathogenesis remain largely unclear, some studies have emphasized upon the crucial role of proinflammatory cytokines and soluble cytokines in triggering a "cytokine storm," which significantly contributes to the pathogenesis of this disease.Clinically, it manifests as seizures and rapid deterioration in consciousness following nonspecific febrile viral illness. 3,4 The hallmark of this condition is the presence of multiple necrotic brain lesions, which exhibit a symmetric distribution, predominantly involving the bilateral thalamus and, rarely, the brainstem tegmentum, cerebral periventricular white matter, and cerebellar medulla.It affects both gray and white matter, and there is neuropathological evidence indicating localized disruption of the blood-brain barrier, referred to as "dysuria." 5 Typically, the prognosis is poor, with fewer than 10% of the patients achieving full recovery, and most are left with focal neurological deficits as sequelae.