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[Risk Factors and Prognosis of Secondary Epilepsy in Children with Viral Encephalitis]
Liang Huang1,2, Dan Yu3, Rong Luo3
1Department of Pharmacy/Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu 610041, China.
Insights
Pediatric viral encephalitis can lead to epilepsy, with risk factors including repetitive seizures and mental/behavior disorders. Early detection and management are crucial for better outcomes in children with post-viral encephalitic epilepsy.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Epileptology
Background:
- Viral encephalitis is a significant cause of neurological morbidity in children.
- Post-infectious epilepsy, particularly post-viral encephalitic epilepsy, presents unique challenges in diagnosis and management.
- Understanding the acute clinical features associated with the development of epilepsy is crucial for timely intervention.
Purpose of the Study:
- To investigate the clinical features of viral encephalitis in children during the acute stage.
- To identify the relationship between these clinical features and the subsequent development of post-viral encephalitic epilepsy.
- To analyze risk factors for the occurrence, control, and prognosis of post-viral encephalitic epilepsy.
Main Methods:
- A cohort of 506 children diagnosed with viral encephalitis was retrospectively analyzed.
- Clinical data, including general condition, manifestations, video electroencephalogram (VEEG), neuroimaging, and virology, were collected.
- Logistic regression was used to determine risk factors for epilepsy development, seizure control, and prognosis.
Main Results:
- 11.46% of children developed epilepsy after a follow-up of over 1.5 years.
- Risk factors for epilepsy included repetitive seizures, detected clinical seizures on EEG, status epilepticus, and mental/behavior disorders.
- While 74.07% of epilepsy cases had favorable seizure control, 41.38% had a poor prognosis, with intellectual and psychomotor retardation being common.
Conclusions:
- Mental/behavior disorders, repetitive seizures, status epilepticus, and EEG-detected seizures are significant risk factors for developing post-viral encephalitic epilepsy in children.
- The specific risk factors contributing to a poor prognosis in these cases require further investigation.
Objectives:
To investigate the clinical features of viral encephalitis in children at acute stage, and the relationship of these clinical features with post viral encephalitic epilepsy.
Methods:
The children with viral encephalitis treated in West China Second University Hospital between January 2010 and January 2014 were enrolled. The clinical features included general conditions, clinical manifestations, video electroencephalogram (VEEG), neuroimaging, virology, prognosis and antiepileptic drugs. The logistic regression model analysis was utilized to analyze the risk factors for the occurrence, bad control, and poor prognosis of post viral encephalitic epilepsy.
Results:
Total 506 children with viral encephalitis were enrolled. Of these, 58(11.46%)developed epilepsy with a follow-up period more than 1.5 years. The logistic regression analysis showed that the risk factors were repetitive seizures (SB =3.602), detection of clinical seizures in EEG (SB =3.061), status epilepticus (SB =2.711) and mental/behavior disorder (SB =1.850). Among 58 epilepsy cases, 40(74.07%) had favorable seizure control, including 37 cases (92.5%) using no more than two kinds of antiepileptic drugs. With Glasgow Outcome Scale, 24 patients (41.38%) had poor prognosis, including 20 cases of intellectual and psychomotor retardation (83.33%), 3 cases of language disorders (12.50%), 1 case of hearing impairment (4.17%), 3 cases of limb dysfunction (12.50%), 3 cases of mortalities (12.50%). Single factor analysis suggested status epilepticus in acute phase had more chance to poor prognosis, but this was not confirmed by logistic regression analysis.
Conclusion:
The risk factors of post viral encephalitic epilepsy in pediatric patients comprise the mental/behavior disorder, repetitive seizures, status epilepticus, and detection of clinical seizures during VEEG monitoring. The risk factors of poor prognosis remain unclear.
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