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Acute Necrotising Encephalopathy (ANE) Therapy at NAPA Centre

Feb 29th, 2024 | by Kate Alexander

Kate Alexander

February 29th, 2024

What is Acute Necrotising Encephalopathy?

Acute necrotizing encephalopathy (ANE) is a rare disease characterised by brain damage (encephalopathy) that typically follows an acute febrile (characterised by fever) disease, often viral infections. In the case of ANE, symptoms of viral infection are followed by seizures and altered consciousness, that may rapidly progress to a coma, liver issues, and neurological impairments. The brain damage is often widespread, affecting all regions of the brain.

What Causes ANE?

ANE is caused by a combination of environmental and genetic factors. It typically develops secondary to a viral infection, such as influenza. ANE can be familial (IT appears to have a genetic component, however, a single genetic cause is unknown) or sporadic (random), however, both forms are similar. Most familial cases are caused by mutations in the RANBP2 gene and are known as infection-induced acute encephalopathy 3 (IIAE3). The exact mechanism of ANE is not yet known.

What Are Some Challenges Children With ANE May Face?

  • Impaired motor function and regression (loss) of motor skills (i.e. sitting, standing, walking, reaching, grasping, object manipulation)
  • Impaired communication – expressive (i.e. using) and or receptive (i.e. understanding) language
  • Vision changes
  • Cognitive changes and possible intellectual disability
  • Fatigue
  • Impaired emotional regulation
  • Inattention (lack of concentration; distraction)
  • Possible increased susceptibility to recurrent infection resulting in further episodes

The presenting symptoms and prognosis (expected outcome) vary widely between cases, ranging from mild forms with complete recovery (10%) to severe forms with high mortality (30%). However, most survivors present with neurological impairments.

Skills lost following the infection may be regained, however the loss of brain tissue is permanent.

What Are Some Treatment Options for ANE?

Whilst there is no cure for ANE, early intervention through multidisciplinary treatment is recommended to support regaining or maintaining gross motor, fine motor, feeding, communication, and cognitive skills.

  • Physiotherapy may focus on increasing muscle strength, coordination, and re-teaching lost motor skills.
  • Occupational therapy may target upper limb strength and functional use to support activities of daily living such as dressing.
  • Speech and language pathology may address receptive and expressive language, and may also support feeding difficulties.

About the Author

Kate is a paediatric physiotherapist at NAPA Centre Sydney. Kate knows that a little bit of fun and laughter is the key to getting the job done. After seeing the benefits of intensive therapy firsthand, Kate is excited to help make a difference in the lives of NAPA kids and their families.

About NAPA Centre 

NAPA Centre provides paediatric therapy services to children diagnosed with Acute Necrotising Encephalopathy. Learn more about treatment options in this blog post.NAPA specialises in working with children with physical and neurological delays. In addition to working with children with more common diagnoses such as cerebral palsy and Down syndrome, NAPA has a special interest and expertise with children with rare, multiple and complex conditions. NAPA Centre’s Intensive Model of Therapy (IMOT) is world-renowned, and one of the leading clinics in Australia for paediatric therapy programs with a large multi-discliplinary team of Occupational Therapists, Physiotherapists and Speech Therapists all working together. Families routinely travel from all parts of Sydney, the NSW region, from across Australia and even from the Australasian region to access NAPA’s unique and effective programs for their children.

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