Long-term neurological outcome in patients presenting with encephalitis

Area of Science:

• Neurology
• Neuroscience
• Clinical Medicine

Background:

• Encephalitis research has advanced acute phase management.
• Long-term outcomes across different encephalitis subtypes remain poorly understood.

Purpose of the Study:

• To analyze the prevalence and predictors of long-term clinical outcomes in various encephalitis subtypes.
• To evaluate neurological sequelae and disability using standardized scales.

Main Methods:

• Retrospective analysis of encephalitis patients discharged from a tertiary neurology hub.
• Classification into autoimmune (AE), infectious (IE), and unknown origin (UE) subtypes.
• Assessment of long-term sequelae via questionnaire and Expanded Disability Status Scale (EDSS).

Main Results:

• Over half of survivors (51.4%) had significant disability (EDSS), and 72.9% reported long-term neurological sequelae.
• Autoimmune encephalitis (AE) showed worse discharge disability and higher relapse risk compared to unknown origin (UE).
• Cognitive deficits (50.0%) and depression (41.4%) were common sequelae; older age and abnormal MRI at onset predicted severe long-term outcomes.

Conclusions:

• Long-term sequelae are prevalent in encephalitis survivors.
• MRI abnormalities, premorbid disability, and older age are key predictors of severe outcomes, irrespective of subtype.
• Further research is needed to identify patients benefiting from cognitive and behavioral training.