Neurological outcomes after presumed childhood encephalitis

Neggy Rismanchi, Jeffrey J. Gold, Shifteh Sattar, Carol Glaser, Heather Sheriff, James Proudfoot, Andrew Mower, Mark Nespeca, John R. Crawford, Sonya G. Wang

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

Objective To evaluate factors during acute presumed childhood encephalitis that are associated with development of long-term neurological sequelae. Methods A total of 217 patients from Rady Children's Hospital San Diego with suspected encephalitis who met criteria for the California Encephalitis Project were identified. A cohort of 99 patients (40 females, 59 males, age 2 months-17 years) without preexisting neurological conditions, including prior seizures or abnormal brain magnetic resonance imaging scans was studied. Mean duration of follow-up was 29 months. Factors that had a relationship with the development of neurological sequelae (defined as developmental delay, learning difficulties, behavioral problems, or focal neurological findings) after acute encephalitis were identified. Results Neurological sequelae at follow-up was associated with younger age (6.56 versus 9.22 years) at presentation (P = 0.04) as well as an initial presenting sign of seizure (P = 0.03). Duration of hospital stay (median of 7 versus 15.5 days; P = 0.02) was associated with neurological sequelae. Of the patients with neurological sequelae, a longer hospital stay was associated with patients of an older age (P = 0.04). Abnormalities on neuroimaging (P = 1.00) or spinal fluid analysis (P = 1.00) were not uniquely associated with neurological sequelae. Children who were readmitted after their acute illness (P = 0.04) were more likely to develop neurological sequelae. There was a strong relationship between the patients who later developed epilepsy and those who developed neurological sequelae (P = 0.02). Significance Limited data are available on the long-term neurological outcomes of childhood encephalitis. Almost half of our patients were found to have neurological sequelae at follow-up, indicating the importance of earlier therapies to improve neurological outcome.

Original languageEnglish (US)
Pages (from-to)200-206
Number of pages7
JournalPediatric Neurology
Volume53
Issue number3
DOIs
StatePublished - Sep 1 2015

Keywords

  • childhood
  • encephalitis
  • neurologic
  • outcomes
  • sequelae

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