Key revisions in the 2023 guidelines for the diagnosis and treatment of acute encephalopathy in childhood.

BACKGROUND: New literature has accumulated since the publication of the guidelines for the diagnosis and treatment of acute encephalopathy in childhood 2016 (GL2016), necessitating the revision of these guidelines. METHODS: In 2020, the working group (WG) of the Japanese Society of Child Neurology began work on publishing a revised version of the GL2016. The WG formulated guidelines using the methodologies recommended by the Medical Information Network Distribution System (Minds). RESULTS: GL2023, published in 2023, includes clinical question 1 (CQ1), based on Minds 2020, and general and specific sections on acute encephalopathy (an update to GL2016) based on Minds 2007. In CQ1, early target temperature management at 36 °C within 24 h was weakly recommended for pediatric cases meeting certain criteria to reduce the risk of progression to acute encephalopathy with biphasic seizures and late reduced diffusion and its sequelae. CONCLUSIONS: GL2023 provides updated recommendations that may improve the diagnosis and management of pediatric acute encephalopathy.