Infantile Hypoxic Encephalopathy Mimicking Acute Encephalopathy with Biphasic Seizures and Late Reduced Diffusion (AESD) Identified as an Episode of Brief Resolved Unexplained Event (BRUE)

Acute encephalopathy with biphasic seizures and reduced diffusion (AESD) is characterized by following febrile viral infections delayed of the cerebral white matter on magnetic resonance imaging (MRI) diffusion-weighted (DWI) (bright tree appearance, BTA). However, hypoxic AESD-mimicking findings has not been reported. We report a case due to suffocation concomitant BTA, mimicking AESD. On day 1, healthy 5-month-old girl was found face down decreased breathing deteriorating consciousness level, suggesting brief resolved unexplained event (BRUE). Electroencephalography (EEG) revealed periodic epileptic discharges, possible nonconvulsive status epilepticus. Despite improvements in level EEG abnormalities 2, her deteriorated again generalized tonic–clonic 3, head MRI-DWI restricted predominantly subcortical areas, BTA. Treatment for acute clinical abnormalities. Persistence abnormal EEG, reflecting excitation accumulation neurotoxic substances caused hypoxia, may have contributed development AESD-like findings. As causes seizures, monitoring seizure occurrence, even after symptoms temporarily improved hypoxia essential.