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Neurobehavioral Assessments in a Mouse Model of Neonatal Hypoxic-ischemic Brain Injury
Published on: November 24, 2017
Neuropsychologic outcomes in children with neonatal herpes encephalitis
Mona-Lisa Engman1, Ingrid Adolfsson, Ilona Lewensohn-Fuchs
1Division of Pediatrics, Department of Clinical Science, Intervention, and Technology, Karolinska University Hospital, Huddinge, Sweden. mona-lisa.engman@ki.se
Insights
Neonatal herpes simplex virus infection significantly impacts cognitive function and speech, even with treatment. Neuropsychological assessment is crucial for habilitation and monitoring disease progression in affected infants.
Area of Science:
- Pediatrics
- Neurology
- Infectious Diseases
Background:
- Neonatal herpes simplex virus (HSV) infection with central nervous system (CNS) involvement presents significant morbidity despite acyclovir therapy.
- Long-term disabilities, including cerebral palsy and cognitive dysfunction, critically affect a child's future habilitation.
Purpose of the Study:
- To define neuropsychological outcomes in children with neonatal HSV CNS infection.
- To determine the relationship between neonatal neuroimaging findings and long-term neuropsychological outcomes.
Main Methods:
- A descriptive cohort study was conducted over 12 years (1989-2000) in the Stockholm area.
- Included 14 infants diagnosed with neonatal herpes CNS infection out of 267,690 births.
- Nine children underwent neuropsychological evaluation.
Main Results:
- Neonatal herpes CNS infection had a profound impact on cognitive function, speech ability, and attention deficit.
- One child experienced relapse with functional deterioration; social skills were less affected.
- Neurodevelopmental outcomes did not strongly correlate with cerebral damage seen on early computed tomography scans.
Conclusions:
- Neuropsychological assessment is vital for the habilitation of children with neonatal herpes CNS infection.
- Assessment is essential for evaluating new treatments and monitoring cerebral function changes related to relapses.
Abstract:
Neonatal herpes simplex virus infection with involvement of the central nervous system is a serious disease with high morbidity, even with acyclovir therapy. The disability includes cerebral palsy and different aspects of cognitive dysfunction which are of utmost importance for the child's future habilitation. We conducted a descriptive cohort study to define neuropsychologic outcomes and determine the relationship between neonatal neuroimaging and neuropsychologic outcomes. Among 267,690 children born in the Stockholm area over 12 years (1989-2000), 14 were diagnosed with neonatal herpes including central nervous system involvement. Nine children were neuropsychologically evaluated. Neonatal herpes virus infection had an even greater impact on cognitive function, speech ability, and attention deficit than anticipated. Relapse leading to deterioration was demonstrated in one child. Social skills were influenced to a lesser degree. Neurodevelopmental outcomes of the children were not well-correlated with extent of cerebral damage as visualized by computed tomography at 7-28 days after onset of signs. Neuropsychologic assessment is essential in the habilitation of the child, and a prerequisite for the evaluation of new treatments and for the assessment of deterioration of cerebral function related to relapses.
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