title: Tick-Borne Encephalitis sequelae at long-term follow-up: a self-reported case-control study.
abstract: BACKGROUND
  Tick-borne encephalitis (TBE), caused by the TBE virus (TBEV), is a major neurotropic infection throughout Europe and Asia, with a considerable risk of neurological sequelae. Our aim was to study the symptoms in patients with TBE in Western Gotaland between 1997 and 2012 in the acute phase and at follow-up after 2-15 years (median: 5.5 years).
  
  
  METHODS
  The medical records of 96 patients with TBE were studied. Phone-based interviews were held with 92 patients and 58 controls, matched by age, gender and residential area. The Encephalitis Support Group Questionnaire (ESGQ) 2000 was used, further developed with dimensions and scoring 1-4, where a high score is related to better outcome. Patients and controls also answered a written survey regarding functional outcome of sleep (FOSQ).
  
  
  RESULTS
  Of the patients, 35% had a mild disease, 56% moderate and 7.3% severe disease. At the follow-up, patients scored significantly lower than controls in the dimensions of memory/learning, executive functions, vigilance and physical impairments. In addition, the answers concerning tiredness/fatigue, poor concentration/attention, reduced initiative/motivation, balance disturbances, coordination problems, difficulties with short- and long-term memory, learning difficulties and problems with fine motor skills resulted in significantly lower scores in the patients compared with the controls. The patients scored lower than the controls in the FOSQ dimension social outcome.
  
  
  CONCLUSIONS
  At the long-term follow-up, the patients scored significantly lower in a diversity of neurocognitive and motor symptoms, in comparison with controls. These sequelae and their pathogenesis should be further explored and specific neurocognitive assessment tests are needed.
authors.affiliation: Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden. malin.veje@vgregion.se.
authors.forename: M
authors.identifier: http://orcid.org/0000-0001-5487-0616
authors.initials: M
authors.lastname: Veje
authors.affiliation: Department for Communicable Disease Control in Western Gotaland, Skövde, Sweden.
authors.forename: P
authors.initials: P
authors.lastname: Nolskog
authors.affiliation: Centre for Applied Biostatistics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Petzold
authors.affiliation: Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Bergström
authors.affiliation: Department of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: T
authors.initials: T
authors.lastname: Lindén
authors.affiliation: Department of Molecular and Clinical Medicine/Cardiology, Sahlgrenska Academy, Gothenburg, Sweden.|Department of Pulmonary Medicine, Faculty of Medicine, Marmara University, Istanbul, Turkey.
authors.forename: Y
authors.initials: Y
authors.lastname: Peker
authors.affiliation: Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: M
authors.initials: M
authors.lastname: Studahl
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003072:Cognition Disorders / Q000209:etiology; D004569:Electroencephalography; D004675:Encephalitis, Tick-Borne / Q000150:complications* / Q000523:psychology; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000209:etiology; D059906:Neuroimaging; D012189:Retrospective Studies; D057566:Self Report; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
keywords: infections; sleep disorders