title: Long-Term Outcomes and Risk Factors Associated With Acute Encephalitis in Children.
abstract: BACKGROUND
  Factors associated with poor outcomes of children with encephalitis are not well known. We sought to determine whether electroencephalography (EEG) findings, magnetic resonance imaging (MRI) abnormalities, or the presence of seizures at presentation were associated with poor outcomes.
  
  
  METHODS
  A retrospective review of patients aged 0 to 21 years who met criteria for a diagnosis of encephalitis admitted between 2000 and 2010 was conducted. Parents of eligible children were contacted and completed 2 questionnaires that assessed current physical and emotional quality of life and neurological deficits at least 1 year after discharge.
  
  
  RESULTS
  During the study period, we identified 142 patients with an International Classification of Diseases 9th Revision diagnosis of meningitis, meningoencephalitis, or encephalitis. Of these patients, 114 met criteria for a diagnosis of encephalitis, and 76 of these patients (representing 77 hospitalizations) had complete data available. Forty-nine (64%) patients were available for follow-up. Patients admitted to the intensive care unit were more likely to have abnormal EEG results (P = .001). The presence of seizures on admission was associated with ongoing seizure disorder at follow-up. One or more years after hospitalization, 78% of the patients had persistent symptoms, including 35% with seizures. Four (5%) of the patients died. Abnormal MRI findings and the number of abnormal findings on initial presentation were associated with lower quality-of-life scores.
  
  
  CONCLUSIONS
  Encephalitis leads to significant morbidity and death, and incomplete recovery is achieved in the majority of hospitalized patients. Abnormal EEG results were found more frequently in critically ill children, patients with abnormal MRI results had lower quality-of-life scores on follow-up, and the presence of seizures on admission was associated with ongoing seizure disorder and lower physical quality-of-life scores.
authors.affiliation: Division of Hospital Medicine and Infectious Diseases.|Department of Pediatrics, Children's Hospital Colorado, Aurora.
authors.forename: Suchitra
authors.initials: S
authors.lastname: Rao
authors.affiliation: Department of Pediatrics, Children's Hospital Colorado, Aurora.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Elkon
authors.affiliation: Division of Pediatric Infectious Diseases, Department of Medicine, Boston Children's Hospital, Massachusetts.
authors.forename: Kelly B
authors.initials: KB
authors.lastname: Flett
authors.affiliation: Adult and Child Center for Health Outcomes and Delivery Science, University of Colorado School of Medicine, and.
authors.forename: Angela F D
authors.initials: AF
authors.lastname: Moss
authors.affiliation: Department of Pediatrics, Children's Hospital Colorado, Aurora.|Divisions of Neurology, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Bernard
authors.affiliation: Department of Neurology, Lee Memorial Health System, Fort Myers, Florida.
authors.forename: Britt
authors.initials: B
authors.lastname: Stroud
authors.affiliation: Hospital Medicine, Department of Pediatrics, University of Colorado School of Medicine, Aurora.
authors.forename: Karen M
authors.initials: KM
authors.lastname: Wilson
mesh_terms: D000293:Adolescent; D001921:Brain / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003120:Colorado; D004569:Electroencephalography; D004660:Encephalitis / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000175:diagnosis / Q000628:therapy; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
keywords: PedsQL; cerebrospinal fluid; encephalitis; meningoencephalitis; viral infection