title: Neurological Outcomes After Presumed Childhood Encephalitis.
abstract: OBJECTIVE
  To evaluate factors during acute presumed childhood encephalitis that are associated with development of long-term neurological sequelae.
  
  
  METHODS
  A total of 217 patients from Rady Children's Hospital San Diego with suspected encephalitis who met criteria for the California Encephalitis Project were identified. A cohort of 99 patients (40 females, 59 males, age 2 months-17 years) without preexisting neurological conditions, including prior seizures or abnormal brain magnetic resonance imaging scans was studied. Mean duration of follow-up was 29 months. Factors that had a relationship with the development of neurological sequelae (defined as developmental delay, learning difficulties, behavioral problems, or focal neurological findings) after acute encephalitis were identified.
  
  
  RESULTS
  Neurological sequelae at follow-up was associated with younger age (6.56 versus 9.22 years) at presentation (P = 0.04) as well as an initial presenting sign of seizure (P = 0.03). Duration of hospital stay (median of 7 versus 15.5 days; P = 0.02) was associated with neurological sequelae. Of the patients with neurological sequelae, a longer hospital stay was associated with patients of an older age (P = 0.04). Abnormalities on neuroimaging (P = 1.00) or spinal fluid analysis (P = 1.00) were not uniquely associated with neurological sequelae. Children who were readmitted after their acute illness (P = 0.04) were more likely to develop neurological sequelae. There was a strong relationship between the patients who later developed epilepsy and those who developed neurological sequelae (P = 0.02).
  
  
  CONCLUSIONS
  Limited data are available on the long-term neurological outcomes of childhood encephalitis. Almost half of our patients were found to have neurological sequelae at follow-up, indicating the importance of earlier therapies to improve neurological outcome.
authors.affiliation: The Department of Neurosciences, University of California, San Diego, California.
authors.forename: Neggy
authors.initials: N
authors.lastname: Rismanchi
authors.affiliation: The Department of Neurosciences, University of California, San Diego, California.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Gold
authors.affiliation: The 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
authors.initials: C
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 Hospital of Orange County Children's Neurology Center, Orange, California.
authors.forename: Andrew
authors.initials: A
authors.lastname: Mower
authors.affiliation: The Department of Neurosciences, University of California, San Diego, California.
authors.forename: Mark
authors.initials: M
authors.lastname: Nespeca
authors.affiliation: The Department of Neurosciences, University of California, San Diego, California.
authors.forename: John R
authors.initials: JR
authors.lastname: Crawford
authors.affiliation: The 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; D002648:Child; D002675:Child, Preschool; D004660:Encephalitis / Q000453:epidemiology* / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D004827:Epilepsy / Q000188:drug therapy / Q000453:epidemiology / Q000473:pathology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male
chemical_list: D000927:Anticonvulsants
keywords: childhood; encephalitis; neurologic; outcomes; sequelae