Acute necrotizing encephalopathy of childhood (ANEC) is a disease, characterized 
by a respiratory or gastrointestinal infection, accompanied with fever, rapid 
alteration of consciousness, and seizures. The clinical characteristics of ANEC 
include acute encephalopathy following a viral infection, seizure, altered 
consciousness, and absence of cerebrospinal fluid (CSF) pleocytosis, with an 
occasional increase in the level of proteins. This disease is almost exclusively 
seen in previously healthy infants and children from East Asia. Serial magnetic 
resonance imaging (MRI) examinations have demonstrated symmetric lesions 
involving the thalami, brainstem, cerebellum, and white matter. ANEC has a poor 
prognosis with high morbidity and mortality rates. Herein, we present three 
cases of ANEC, who were referred to Bu-Ali Hospital of Ardabil, Iran during two 
weeks. Report of these three cases promoted the idea of an epidemic. The purpose 
of this case series was to raise the issue that ANEC may occur as an epidemic.