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Published on: March 17, 2014
Neurodevelopment medium-term outcome after parechovirus infection
Fernando Martín Del Valle1, Ana Menasalvas Ruiz2, Amaia Cilla3
1Department of Pediatrics, Hospital Universitario Severo Ochoa, Av. Orellana s/n, 28911 Leganés, Madrid, Spain.
Insights
Human parechovirus (HPeV) infections in infants show good medium-term outcomes, with most motor deficits resolving. Early intervention aids recovery in children with HPeV without encephalitis.
Area of Science:
- Pediatrics
- Infectious Diseases
- Neurology
Background:
- Human parechoviruses (HPeV) cause fever, sepsis-like illness, and encephalitis in young children.
- Long-term neurodevelopmental outcomes after HPeV infection are a significant concern for infants.
- This study focuses on the medium-term prognosis of infants with HPeV infection, specifically excluding encephalitis cases.
Purpose of the Study:
- To evaluate the medium-term neurodevelopmental outcomes in infants following human parechovirus infection.
- To assess the recovery trajectory of motor function in infants after HPeV infection without encephalitis.
Main Methods:
- Infants with HPeV infection involving cerebrospinal fluid were assessed twice using the Ages and Stages Questionnaire-3 (ASQ-3).
- The first assessment occurred at least one year post-infection, with a follow-up assessment one year later.
- Neurological examinations were also performed to identify motor deficits.
Main Results:
- Initially, 3 out of 16 infants showed mild motor function alterations; one had hypotonia and another hemiparesis.
- At the second assessment (15 patients), only the patient with hemiparesis still exhibited gross motor dysfunction.
- The remaining patients demonstrated complete recovery, indicating significant improvement over the follow-up period.
Conclusions:
- Infants infected with human parechovirus without encephalitis generally exhibit a good medium-term prognosis.
- Mild motor alterations observed post-infection can improve, particularly with at-home interventions.
- Outcomes for HPeV infection without encephalitis appear more favorable compared to cases involving encephalitis.
Aim:
Human parechoviruses (HPeV) are responsible for fever without a source (FWS), sepsis-like illness and encephalitis in neonates and children under 3 months of age. Short-term outcome is generally good, but there is great concern about medium and long- term outcome of infants after HPeV infection. The aim of this study is to assess the medium-term outcome in infants following HPeV infection without encephalitis.
Methods:
Patients who suffered HPeV infection involving cerebrospinal fluid were evaluated twice using Ages and Stages Questionnaire-3 (ASQ-3). The first evaluation was conducted at least one year after the infection and the second one year later.
Results:
Sixteen patients were evaluated in the first assessment, and three of them presented mild alterations in motor function domains. Moreover, hypotonia was observed in the neurologic exam in one case, and hemiparesis in another case. In the second assessment fifteen patients were included, and only the patient with hemiparesis continued presenting gross motor disfunction, with complete recovery of the remaining patients.
Interpretation:
We have observed a good medium-term prognosis in infants after HPeV infections, with improvement of mild motor alterations after at-home intervention. Infants who suffer HPeV infection without encephalitis seem to have a better prognosis than those with encephalitis.
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