title: Epilepsy After Resolution of Presumed Childhood Encephalitis.
abstract: OBJECTIVE
  To evaluate factors associated with the development of epilepsy after resolution of presumed childhood encephalitis.
  
  
  METHODS
  A total of 217 patients with suspected encephalitis who met criteria for the California Encephalitis Project were identified. Evaluable outcome information was available for 99 patients (40 girls, 59 boys, ages 2 months to 17 years) without preexisting neurological conditions, including prior seizures or abnormal brain magnetic resonance imaging scans. We identified factors correlated with the development of epilepsy after resolution of the acute illness.
  
  
  RESULTS
  Development of epilepsy was correlated with the initial presenting sign of seizure (P < 0.001). With each additional antiepileptic drug used to control seizures, the odds ratio of developing epilepsy was increased twofold (P < 0.001). An abnormal electroencephalograph (P < 0.05) and longer hospital duration (median of 8 versus 21 days) also correlated with development of epilepsy (P < 0.01). The need for medically induced coma was associated with epilepsy (P < 0.001). Seizures in those patients were particularly refractory, often requiring longer than 24 hours to obtain seizure control. Individuals who required antiepileptic drugs at discharge (P < 0.001) or were readmitted after their acute illness (P < 0.001) were more likely to develop epilepsy. Of our patients who were able to wean antiepileptic drugs after being started during hospitalization, 42% were successfully tapered off within 6 months.
  
  
  CONCLUSIONS
  Limited data are available on the risk of developing epilepsy after childhood encephalitis. This is the first study that not only identifies risk factors for the development of epilepsy, but also provides data regarding the success rate of discontinuing antiepileptic medication after resolution of encephalitis.
authors.affiliation: Department of Neurosciences, University of California, San Diego, California.
authors.forename: Neggy
authors.initials: N
authors.lastname: Rismanchi
authors.affiliation: Department of Neurosciences, University of California, San Diego, California.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Gold
authors.affiliation: Department of Neurosciences, University of California, San Diego, California.
authors.forename: Shifteh
authors.initials: S
authors.lastname: Sattar
authors.affiliation: California Department of Public Health, Richmond, California.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Glaser
authors.affiliation: California Department of Public Health, Richmond, California.
authors.forename: Heather
authors.initials: H
authors.lastname: Sheriff
authors.affiliation: Biostatistics Unit, Clinical and Translational Research Institute, University of California, San Diego, California.
authors.forename: James
authors.initials: J
authors.lastname: Proudfoot
authors.affiliation: Children's Neurology Center, Children's Hospital of Orange County, Orange, California.
authors.forename: Andrew
authors.initials: A
authors.lastname: Mower
authors.affiliation: Department of Neurosciences, University of California, San Diego, California.
authors.forename: John R
authors.initials: JR
authors.lastname: Crawford
authors.affiliation: Department of Neurosciences, University of California, San Diego, California.
authors.forename: Mark
authors.initials: M
authors.lastname: Nespeca
authors.affiliation: Department of Neurosciences, University of California, San Diego, California. Electronic address: sgwang@ucsd.edu.
authors.forename: Sonya G
authors.initials: SG
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000473:pathology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004569:Electroencephalography; D004660:Encephalitis / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008279:Magnetic Resonance Imaging; D008297:Male; D012307:Risk Factors; D012640:Seizures / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology
chemical_list: D000927:Anticonvulsants
keywords: Epilepsy; childhood; encephalitis; seizures