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Risk factors for secondary epilepsy in children with viral encephalitis
Yun Cheng1, Rui Wang1, Mingnong Xia1
1Department of Pediatrics, Lu'an People's Hospital Affiliated to Anhui Medical University Lu'an 237000, Anhui, China.
Insights
Secondary epilepsy (EP) affects over a quarter of children with viral encephalitis. Key risk factors include not using antiepileptic drugs, high white blood cell counts in cerebrospinal fluid, and abnormal EEG results.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Epileptology
Background:
- Viral encephalitis is a significant cause of neurological morbidity in children.
- Secondary epilepsy (EP) is a known complication of viral encephalitis, impacting patient outcomes.
- Understanding the incidence and risk factors for secondary EP is crucial for timely intervention.
Purpose of the Study:
- To determine the incidence of secondary epilepsy in children diagnosed with viral encephalitis.
- To describe the clinical manifestations and electroencephalogram (EEG) findings in these children.
- To identify independent risk factors associated with the development of secondary EP.
Main Methods:
- Retrospective analysis of 130 children with viral encephalitis.
- Comparison of clinical symptoms, cerebrospinal fluid (CSF) indices, and EEG findings between children with and without secondary EP.
- Multivariate logistic regression to identify independent risk factors for secondary EP.
Main Results:
- The incidence of secondary EP was 27.69% (36/130 children).
- Vomiting and coma were more frequent in the secondary EP group (P<0.05).
- Independent risk factors identified: non-use of antiepileptic drugs (P=0.039), elevated CSF white blood cell count (P=0.006), and moderate to severe abnormal EEG results (P=0.041).
Conclusions:
- Secondary epilepsy occurs frequently in children with viral encephalitis.
- Prompt use of antiepileptic drugs, monitoring CSF white blood cell counts, and interpreting EEG findings are important.
- Identifying these risk factors aids in managing and potentially preventing secondary EP in this vulnerable population.
Objective:
To investigate the clinical manifestations of secondary epilepsy (EP) in children with viral encephalitis and to identify any associated risk factors.
Methods:
A retrospective analysis was conducted on 130 children with viral encephalitis treated at Lu'an People's Hospital Affiliated with Anhui Medical University between December 2021 and October 2024. Of these, 36 children who developed secondary EP were classified as the EP group, and 94 children without secondary EP were categorized as the non-EP group. The overall incidence of secondary EP, clinical symptoms, cerebrospinal fluid (CSF) indices, and electroencephalogram (EEG) findings were compared between the groups. Multivariate logistic regression analysis was employed to identify independent risk factors for the development of secondary EP.
Results:
Of the 130 children with viral encephalitis, 36 (27.69%) developed secondary EP. Among them, 10 children (27.78%) had self-limited generalized EP, and 26 children (72.22%) had self-limited focal EP. Status epilepticus occurred in 7/36 cases (19.44%), but not in the other 29/36 cases (80.56%). No notable differences were observed in fever, headache, drowsiness, and coma between the EP group and non-EP group (P>0.05). However, vomiting and coma were significantly more frequent in the EP group (P<0.05). Abnormal EEG findings were also more prevalent in the EP group compared to the non-EP group (P<0.05). Logistic regression analysis identified non-use of antiepileptic drugs (P=0.039; CI: 0.181-0.958), elevated white blood cell count in CSF (P=0.006; CI: 1.028-1.185), and moderate to severe abnormal EEG results (P=0.041; CI: 1.035-5.41) as independent risk factors for the occurrence of secondary EP in children with viral encephalitis.
Conclusion:
The incidence of secondary EP in children with viral encephalitis is relatively high. Non-use of antiepileptic drugs, elevated white blood cell count in the CSF, and moderate to severe abnormal EEG results were independent risk factors for the occurrence of secondary EP in children with viral encephalitis.
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