TNF Inhibitors and IL6 Blockers
Favorable Outcomes With Early Interleukin 6 Receptor Blockade in Severe Acute Necrotizing Encephalopathy of childhood. https://www.pedneur.com/article/S0887-8994(19)30144-4/fulltext
coma inducing drugs
Procedural & Diagnostic Tools
MRI and CT Scan – These 2 medical tests are used to examine the structure of the brain and scan in cross sections. The MRI uses magnetic fields and the CT uses x-rays. The MRI may see an injury to the brain that can go undetected in a CT scan as it has a higher resolution.
EEG – Using electrodes placed on the skull, an EEG records electrical signals coming from the brain. A slowing of these signals may indicate a lesion whilst widespread slowing may indicate a wider disturbance of the brain function. An EEG may be used to confirm diagnosis from other tests.
Intracranial Pressure Monitor – Doctors may insert one of these monitors into the skull if they are concerned about pressure from inflammation in the acute stage of injury.
Lumbar Puncture – This is a diagnostic test where fluid is extracted from the spinal column. Pressure on the spinal column is measured and the cerebro-spinal (CSF) fluid is then examined for viral cultures, elevated white cell counts and blood. In the majority of cases, ANE patient’s CSF will show elevated protein and no viral pathogen.
Breathing Assistance – A Tracheal Intubation or Tracheotomy is sometimes performed, as well as careful montoring of breathing and heart function.
Genetic Testing – It is becoming more common to have ANE patients tested for the genetic mutations. It is a simple blood test. Some hospitals will do the testing as a matter of course. Testing may be done “in house” at the hospital, if they they have the facilities to do so. However, some hospitals may send the samples overseas to an appropriate testing facility.
Medical Assistance & Other Medications
These drugs can help stop or prevent seizures. Most ANE patients will have seizures at the onset of ANE. These seizures can be quite dramatic (tonic/clonic) or almost unnoticable (focal or generalized). Anti convulsant medication may have a sedative effect. The most common drug used is Keppra. For a list of other types of anti convulsant medication see –
These drugs may sometimes be used in post-traumatic brain injury to treat agitation, disruptive behaviour and/or agressive behaviour as the brain heals.
This is an anti viral drug used for the treatment of influenza. It works by slowing down the rate at which viruses infect cells. It does not eliminate the flu virus, rather it slows its progress. It needs to be taken early in the infection cycle and hence some ANE patient’s treating physicians may recommend it be taken at the first sign of influenza or viral illness to guard against recurrence of ANE.
Sometimes, Melatonin is prescribed to helps control the sleep and wake cycles in ANE patients and other ABI patients.
Until a bacterial infection is ruled out, antibiotics can sometimes be used for prophylactic measures. These will be used if ANE is caused by a bacteria.
Nasogastric Intubation (NgTube via the nasal passage) or Gastric Intubation (GTube via abdomen walls) is a common procedure that provides access to the stomach for feeding.
Intravenous Fluids (IV’s)
Intravenous therapy is the infusion of liquid substances directly into a vein. ANE patients may have the following fluids administered through an IV line. Rehydration fluids after becoming dehydrated, antibiotics , steroids and pain management medications.