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[Outcome of herpetic encephalitis. Apropos of 10 cases]
J Mancini1, B Chabrol, M O Livet
1Service de Neurologie Pédiatrique, Hôpital d'Enfants de la Timone, Marseille.
Insights
Herpetic encephalitis in children often leads to poor outcomes, including epilepsy and neurodevelopmental impairment. Recurrent disease and specific neuropsychological patterns, like Kluver-Bucy syndrome, are significant concerns in pediatric cases.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Neurovirology
Context:
- Herpetic encephalitis (HE) is a severe neurological condition in children.
- Diagnosis relies on electroclinical and neuroradiological findings, with biological confirmation in only 50% of cases.
- This retrospective review examines ten pediatric cases of HE.
Purpose:
- To retrospectively review ten pediatric cases of herpetic encephalitis.
- To analyze clinical presentation, diagnostic criteria, and patient outcomes.
- To discuss factors contributing to poor outcomes, recurrent disease, and specific neuropsychological sequelae.
Summary:
- Ten children (2 months to 13.5 years) with herpetic encephalitis were analyzed.
- Two patients died during the initial episode; seven were followed for 2-10 years.
- Significant rates of epilepsy (5/7) and neurodevelopmental impairment (6/7) were observed.
- Recurrent encephalitis occurred in three patients, with two exhibiting Kluver-Bucy syndrome.
Impact:
- Highlights the significant long-term morbidity associated with pediatric herpetic encephalitis.
- Underscores the need for improved diagnostic strategies and long-term management protocols.
- Informs understanding of the varied neuropsychological deficits and recurrent disease patterns in childhood HE.
Abstract:
Ten cases of herpetic encephalitis in children aged 2 months to 13 1/2 years at onset are reviewed retrospectively. There were four infants and six children 3 to 13 1/2 years old. Diagnosis was established on the basis of widely accepted electroclincal and neuroradiological criteria. Biologic confirmation was obtained in only half the cases. Two patients died during the initial episode. One patient was lost to follow-up two months after the first episode. Follow-ups ranged from 2 to 10 years for the seven remaining patients. Epilepsy and neurodevelopmental impairment occurred in a significant number of cases (5/7 and 6/7 respectively). Two patients had two episodes and one had more than two episodes of encephalitis. This poor outcome is discussed, as well as possible explanations for recurrent disease and particular neuropsychologic patterns, including Kluver-Bucy syndrome seen in two patients of this series.