EEG abnormalities are associated with increased risk of transplant or poor outcome in children with acute liver failure

Hussain, E.; Grimason, M.; Goldstein, J.; Smith, C. M.; Alonso, E.; Whitington, P. F.; Wainwright, M. S.

J Pediatr Gastroenterol Nutr. 2013 Dec 19; 58(4):449-56


OBJECTIVES: There are limited data on the incidence of seizures and utility of brain imaging and electroencephalogram (EEG) to predict outcome of children with acute liver failure (ALF). We investigated the association between hepatic encephalopathy (HE) scores, abnormal EEG or neuroimaging, and short-term outcome. METHODS: Single-center retrospective observational study of infants and children with ALF who underwent continuous EEG monitoring and brain imaging within 24 hours of admission to the intensive care unit (ICU). RESULTS: A total of 19 patients with ALF with a mean age of 6.8 +/- 1.5 years were evaluated. The majority of cases (74%) were indeterminate. Of the total, 10 patients (53%) survived to discharge without liver transplant (LT), 5 (26%) received LT, and 4 (21%) died without LT. Seizures occurred in only 2 cases (19%). Patients who had an abnormal EEG on admission (n = 7) were significantly more likely to die or require LT (P < 0.05, Fisher exact test). Patients with either an admission HE score

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