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Functional status of children with encephalitis in an inpatient rehabilitation setting: a case series
Yogita I Tailor1, Stacy J Suskauer, Leigh N Sepeta
1Department of Physical Medicine and Rehabilitation, Sinai Hospital of Baltimore, Baltimore, MD, USA.
Insights
Pediatric inpatient rehabilitation significantly improves functional outcomes for children with encephalitis. However, predictors of recovery remain unclear, necessitating further research into this neurological condition.
Area of Science:
- Pediatric Rehabilitation
- Pediatric Neurology
- Neuroscience
Background:
- Recovery patterns and predictors following encephalitis are not well understood.
- Encephalitis can lead to significant functional impairments in children.
Purpose of the Study:
- To examine functional status and clinical features of children with encephalitis undergoing inpatient rehabilitation.
- To evaluate functional recovery during pediatric inpatient rehabilitation.
Main Methods:
- Retrospective chart review of children with encephalitis (1996-2010).
- Functional status assessed using the Functional Independence Measure for Children (WeeFIM) scores.
- Analysis of WeeFIM domain scores (Self-care, Mobility, Cognitive) and Total Developmental Functional Quotient (DFQ).
Main Results:
- A total of 13 children were included, with a mean age of 9 years.
- Significant improvement in mean WeeFIM Total DFQ from 37 at admission to 64 at discharge (p < 0.001).
- All WeeFIM domain scores showed significant improvement; 11 children had functional impairments (DFQ ≤ 85) at discharge.
Conclusions:
- Inpatient rehabilitation leads to substantial functional gains in children with encephalitis.
- Clinical features did not predict functional outcomes.
- Further research is needed to identify specific predictors of recovery in pediatric encephalitis.
Introduction:
Patterns and predictors of recovery from encephalitis are poorly understood.
Methods:
This study examined functional status and reviewed charts of all children who presented to a pediatric inpatient rehabilitation facility with encephalitis between 1996 and 2010. Functional status at admission and discharge from inpatient rehabilitation was evaluated using the Functional Independence Measure for Children (WeeFIM) Self-care, Mobility, Cognitive, and Total Developmental Functional Quotient scores (DFQ, % of age-appropriate function). Charts were reviewed to characterize key clinical features and findings.
Results:
Of the 13 children identified, the mean age was 9 years (range 5-16) with 54% males. Mean WeeFIM Total DFQ at admission was 37 (range: 15-90) and at discharge was 64 (range: 16-96). Average change in WeeFIM Total DFQ from admission to discharge was 26.7 (range 0-55, p < 0.001). WeeFIM domain scores improved between admission and discharge (Self-Care: p < 0.001, Cognition: p < 0.01, Mobility: p < 0.001). Eleven children displayed significant impairments in functional skills, defined as DFQ of < or =85, at discharge. Key clinical features and findings were diverse and not related to functional outcome.
Conclusions:
Results suggest that significant functional improvement in children with encephalitis occurs during inpatient rehabilitation. Further research is necessary to identify predictors of outcome in children with encephalitis.
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