Long-term outcomes of acute encephalitis in childhood.
OBJECTIVE
The aims of this study were to investigate the long-term outcomes of childhood encephalitis and to examine possible prognostic factors.


METHODS
Of 93 children who were treated for acute encephalitis in 2000-2004, 71 were eligible for follow-up evaluations. A structured interview, using 2 questionnaires, was conducted with the parents. Fifteen of the children with the most-severe symptoms at the time of discharge also underwent electroencephalographic recording and tests of reaction times and working memory.


RESULTS
Persisting symptoms were reported by 54% of children. The predominant symptoms were personality changes and cognitive problems. Children who made a complete recovery did so within 6 to 12 months. The only significant risk factor for sequelae was disease severity leading to admission to the ICU. The risk of subsequent epilepsy was increased for children with seizures at presentation. Most follow-up electroencephalograms showed improvement, but results had not normalized for 9 of 15 children. Children with encephalitis had slower reaction times, compared with control subjects, but no difference in working memory could be seen.


CONCLUSIONS
Persisting symptoms after childhood encephalitis were present for a substantial number of children. Seizures increased the risk of subsequent epilepsy; the only other prognostic marker was admission to the ICU. Even children who were considered fully recovered at discharge reported persisting symptoms at follow-up evaluations. Children who made a full recovery did so within 6 to 12 months, which suggests that all children with encephalitis should be monitored for 1 year after the acute illness.
Fowler
Asa
A
Neuropediatric Unit, Department of Women's and Children's Health, Q2:07, ALB, Karolinska University Hospital, 171 76 Stockholm, Sweden. asa.fowler@ki.se
Stödberg
Tommy
T
Eriksson
Margareta
M
Wickström
Ronny
R
D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology; D004569:Electroencephalography; D004660:Encephalitis / Q000150:complications* / Q000523:psychology; D004827:Epilepsy / Q000209:etiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010551:Personality; D011379:Prognosis; D011795:Surveys and Questionnaires