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ENCEPHALOPATHY, ACUTE TRANSIENT(ENPAT)

MedGen UID:
1052386
•Concept ID:
CN378529
•
Disease or Syndrome
Synonym: ENPAT
 
Gene (location): ABCB1 (7q21.12)
 
OMIM®: 620950

Definition

Acute transient encephalopathy (ENPAT) is characterized by episodes of neurologic dysfunction following treatment with specific medications or onset of acute illness. Neurologic signs include ataxia, spasticity, pyramidal signs, diplopia, vomiting, obtundation, and coma. Symptoms fully resolve in 24 to 48 hours (Baudou et al., 2020; Seo et al., 2020). [from OMIM]

Professional guidelines

PubMed

Diagnosis and Management of Headache: A Review.
Robbins MS
JAMA 2021 May 11;325(18):1874-1885. doi: 10.1001/jama.2021.1640. PMID: 33974014
Diagnosis and Management of Transient Ischemic Attack and Acute Ischemic Stroke: A Review.
Mendelson SJ, Prabhakaran S
JAMA 2021 Mar 16;325(11):1088-1098. doi: 10.1001/jama.2020.26867. PMID: 33724327
Acute Brain Failure: Pathophysiology, Diagnosis, Management, and Sequelae of Delirium.
Maldonado JR
Crit Care Clin 2017 Jul;33(3):461-519. doi: 10.1016/j.ccc.2017.03.013. PMID: 28601132

Recent clinical studies

Etiology

Diagnosis, Workup, Risk Reduction of Transient Ischemic Attack in the Emergency Department Setting: A Scientific Statement From the American Heart Association.
Amin HP, Madsen TE, Bravata DM, Wira CR, Johnston SC, Ashcraft S, Burrus TM, Panagos PD, Wintermark M, Esenwa C; American Heart Association Emergency Neurovascular Care Committee of the Stroke Council and Council on Peripheral Vascular Disease
Stroke 2023 Mar;54(3):e109-e121. Epub 2023 Jan 19 doi: 10.1161/STR.0000000000000418. PMID: 36655570
Diagnosis and Management of Headache: A Review.
Robbins MS
JAMA 2021 May 11;325(18):1874-1885. doi: 10.1001/jama.2021.1640. PMID: 33974014
Clopidogrel With Aspirin in Acute Minor Stroke or Transient Ischemic Attack (CHANCE) Trial: One-Year Outcomes.
Wang Y, Pan Y, Zhao X, Li H, Wang D, Johnston SC, Liu L, Meng X, Wang A, Wang C, Wang Y; CHANCE Investigators
Circulation 2015 Jul 7;132(1):40-6. Epub 2015 May 8 doi: 10.1161/CIRCULATIONAHA.114.014791. PMID: 25957224
Neurological consequences of traumatic brain injuries in sports.
Ling H, Hardy J, Zetterberg H
Mol Cell Neurosci 2015 May;66(Pt B):114-22. Epub 2015 Mar 12 doi: 10.1016/j.mcn.2015.03.012. PMID: 25770439
Guidelines for management of ischaemic stroke and transient ischaemic attack 2008.
European Stroke Organisation (ESO) Executive Committee; ESO Writing Committee
Cerebrovasc Dis 2008;25(5):457-507. Epub 2008 May 6 doi: 10.1159/000131083. PMID: 18477843

Diagnosis

Inpatient Management of Acute Stroke and Transient Ischemic Attack.
Patrick L, Halabi C
Neurol Clin 2022 Feb;40(1):33-43. doi: 10.1016/j.ncl.2021.08.003. PMID: 34798973
Contrast-induced encephalopathy.
Babalova L, Ruzinak R, Ballova J, Sivak S, Kantorova E, Kurca E, Zelenak K, Nosal V
Bratisl Lek Listy 2021;122(9):618-620. doi: 10.4149/BLL_2021_098. PMID: 34463105
Cerebral Amyloid Angiopathy-Related Transient Focal Neurologic Episodes.
Smith EE, Charidimou A, Ayata C, Werring DJ, Greenberg SM
Neurology 2021 Aug 3;97(5):231-238. Epub 2021 May 20 doi: 10.1212/WNL.0000000000012234. PMID: 34016709Free PMC Article
Diagnosis and Management of Headache: A Review.
Robbins MS
JAMA 2021 May 11;325(18):1874-1885. doi: 10.1001/jama.2021.1640. PMID: 33974014
Management of concussion in soccer.
Hubertus V, Marklund N, Vajkoczy P
Acta Neurochir (Wien) 2019 Mar;161(3):425-433. Epub 2019 Jan 28 doi: 10.1007/s00701-019-03807-6. PMID: 30687899

Therapy

Clinical Updates on Antiplatelet Therapy for Secondary Prevention in Acute Ischemic Stroke.
Lee TL, Chang YM, Sung PS
Acta Neurol Taiwan 2023 Sep 30;32(3):138-144. PMID: 37674428
Comparison of Ticagrelor vs Clopidogrel in Addition to Aspirin in Patients With Minor Ischemic Stroke and Transient Ischemic Attack: A Network Meta-analysis.
Lun R, Dhaliwal S, Zitikyte G, Roy DC, Hutton B, Dowlatshahi D
JAMA Neurol 2022 Feb 1;79(2):141-148. doi: 10.1001/jamaneurol.2021.4514. PMID: 34870698Free PMC Article
Contrast-induced encephalopathy.
Babalova L, Ruzinak R, Ballova J, Sivak S, Kantorova E, Kurca E, Zelenak K, Nosal V
Bratisl Lek Listy 2021;122(9):618-620. doi: 10.4149/BLL_2021_098. PMID: 34463105
Diagnosis and Management of Headache: A Review.
Robbins MS
JAMA 2021 May 11;325(18):1874-1885. doi: 10.1001/jama.2021.1640. PMID: 33974014
Clopidogrel With Aspirin in Acute Minor Stroke or Transient Ischemic Attack (CHANCE) Trial: One-Year Outcomes.
Wang Y, Pan Y, Zhao X, Li H, Wang D, Johnston SC, Liu L, Meng X, Wang A, Wang C, Wang Y; CHANCE Investigators
Circulation 2015 Jul 7;132(1):40-6. Epub 2015 May 8 doi: 10.1161/CIRCULATIONAHA.114.014791. PMID: 25957224

Prognosis

Toxic leukoencephalopathies.
Bandeira GA, Lucato LT
Handb Clin Neurol 2024;204:455-486. doi: 10.1016/B978-0-323-99209-1.00006-5. PMID: 39322394
Clinical Characteristics, Management, and In-Hospital Outcomes in Patients With Stroke or Transient Ischemic Attack in China.
Gu HQ, Yang X, Wang CJ, Zhao XQ, Wang YL, Liu LP, Meng X, Jiang Y, Li H, Liu C, Wangqin R, Fonarow GC, Schwamm LH, Xian Y, Li ZX, Wang YJ
JAMA Netw Open 2021 Aug 2;4(8):e2120745. doi: 10.1001/jamanetworkopen.2021.20745. PMID: 34387677Free PMC Article
Acute stroke differential diagnosis: Stroke mimics.
Vilela P
Eur J Radiol 2017 Nov;96:133-144. Epub 2017 May 5 doi: 10.1016/j.ejrad.2017.05.008. PMID: 28551302
Epidemiology of stroke and transient ischemic attacks: Current knowledge and perspectives.
Béjot Y, Daubail B, Giroud M
Rev Neurol (Paris) 2016 Jan;172(1):59-68. Epub 2015 Dec 21 doi: 10.1016/j.neurol.2015.07.013. PMID: 26718592
Clopidogrel With Aspirin in Acute Minor Stroke or Transient Ischemic Attack (CHANCE) Trial: One-Year Outcomes.
Wang Y, Pan Y, Zhao X, Li H, Wang D, Johnston SC, Liu L, Meng X, Wang A, Wang C, Wang Y; CHANCE Investigators
Circulation 2015 Jul 7;132(1):40-6. Epub 2015 May 8 doi: 10.1161/CIRCULATIONAHA.114.014791. PMID: 25957224

Clinical prediction guides

The Third China National Stroke Registry (CNSR-III) for patients with acute ischaemic stroke or transient ischaemic attack: design, rationale and baseline patient characteristics.
Wang Y, Jing J, Meng X, Pan Y, Wang Y, Zhao X, Lin J, Li W, Jiang Y, Li Z, Zhang X, Yang X, Ji R, Wang C, Wang Z, Han X, Wu S, Jia Z, Chen Y, Li H
Stroke Vasc Neurol 2019 Sep;4(3):158-164. Epub 2019 Jun 29 doi: 10.1136/svn-2019-000242. PMID: 31709123Free PMC Article
Acute stroke differential diagnosis: Stroke mimics.
Vilela P
Eur J Radiol 2017 Nov;96:133-144. Epub 2017 May 5 doi: 10.1016/j.ejrad.2017.05.008. PMID: 28551302
Semi-automatic software based detection of atrial fibrillation in acute ischaemic stroke and transient ischaemic attack.
Nickelsen MN, Snoer A, Ali AM, Wienecke T
Eur J Neurol 2017 Feb;24(2):322-325. Epub 2016 Dec 7 doi: 10.1111/ene.13199. PMID: 27928866
Medical treatment in acute and long-term secondary prevention after transient ischaemic attack and ischaemic stroke.
Rothwell PM, Algra A, Amarenco P
Lancet 2011 May 14;377(9778):1681-92. doi: 10.1016/S0140-6736(11)60516-3. PMID: 21571151
Transient ischemic attacks--definition, risk prediction and urgent management.
Sylaja PN, Hill MD
Neurol India 2009 May-Jun;57(3):252-6. doi: 10.4103/0028-3886.53262. PMID: 19587463

Recent systematic reviews

Risk factors for cognitive impairment and dementia after stroke: a systematic review and meta-analysis.
Filler J, Georgakis MK, Dichgans M
Lancet Healthy Longev 2024 Jan;5(1):e31-e44. Epub 2023 Dec 12 doi: 10.1016/S2666-7568(23)00217-9. PMID: 38101426
Post-stroke sleep disturbance and recurrent cardiovascular and cerebrovascular events: A systematic review and meta-analysis.
Hale E, Gottlieb E, Usseglio J, Shechter A
Sleep Med 2023 Apr;104:29-41. Epub 2023 Feb 20 doi: 10.1016/j.sleep.2023.02.019. PMID: 36889030Free PMC Article
Efficacy and Safety of Ketamine vs Electroconvulsive Therapy Among Patients With Major Depressive Episode: A Systematic Review and Meta-analysis.
Rhee TG, Shim SR, Forester BP, Nierenberg AA, McIntyre RS, Papakostas GI, Krystal JH, Sanacora G, Wilkinson ST
JAMA Psychiatry 2022 Dec 1;79(12):1162-1172. doi: 10.1001/jamapsychiatry.2022.3352. PMID: 36260324Free PMC Article
Comparison of Ticagrelor vs Clopidogrel in Addition to Aspirin in Patients With Minor Ischemic Stroke and Transient Ischemic Attack: A Network Meta-analysis.
Lun R, Dhaliwal S, Zitikyte G, Roy DC, Hutton B, Dowlatshahi D
JAMA Neurol 2022 Feb 1;79(2):141-148. doi: 10.1001/jamaneurol.2021.4514. PMID: 34870698Free PMC Article
Acute Treatments for Episodic Migraine in Adults: A Systematic Review and Meta-analysis.
VanderPluym JH, Halker Singh RB, Urtecho M, Morrow AS, Nayfeh T, Torres Roldan VD, Farah MH, Hasan B, Saadi S, Shah S, Abd-Rabu R, Daraz L, Prokop LJ, Murad MH, Wang Z
JAMA 2021 Jun 15;325(23):2357-2369. doi: 10.1001/jama.2021.7939. PMID: 34128998Free PMC Article

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      Related records in OMIM
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