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Neurological prognostic factors for human herpes virus 6/7-associated acute encephalopathy in children: A

Yoshihiro Watanabe1, Mao Odaka1, Hirotaka Motoi1

  • 1Children's Medical Center, Yokohama City University Medical Center, Yokohama, Japan.

Brain & Development
|December 12, 2022
PubMed

Insights

Coma during acute human herpes virus 6/7-associated acute encephalopathy (AE) is a key predictor of severe neurological outcomes. Early identification of coma aids in predicting long-term sequelae in affected children.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases
  • Neuroscience

Background:

  • Human herpes virus (HHV) 6/7-associated acute encephalopathy (AE) is a serious condition in children.
  • Identifying prognostic factors is crucial for managing severe neurological sequelae and epileptic seizures.

Purpose of the Study:

  • To determine prognostic factors for severe neurological sequelae and epileptic seizures in children with HHV-6/7-associated AE.
  • To differentiate between severe (PCPC ≥ 3) and non-severe (PCPC ≤ 2) neurological sequelae.

Main Methods:

  • Retrospective study of pediatric HHV6/7-associated AE cases (April 2011-March 2021).
  • Neurological sequelae assessed using Pediatric Cerebral Performance Category (PCPC) scale one year post-onset.
  • Prognostic factors analyzed, comparing severe vs. non-severe sequelae groups.

Main Results:

  • Forty children (4-95 months) were included; 28 had AE with biphasic seizures and late reduced diffusion.
  • Coma in the acute phase, thalamic MRI lesions, and elevated liver enzymes (AST, ALT, LDH) were more frequent in the severe sequelae group.
  • Multivariate analysis confirmed coma as a significant factor for severe neurological sequelae (p=0.0405).

Conclusions:

  • Coma during the acute phase is a significant prognostic factor for severe neurological sequelae in HHV-6/7-associated AE.
  • While epileptic seizures, thalamic lesions, and elevated ALT/urinary beta 2-microglobulin were noted, coma emerged as the primary predictor.
Abstract

Keywords:
Acute encephalopathyComaEpilepsyHuman herpes virus 6/7Prognosis

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