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KMID : 0391520160240030143
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Journal of the Korean Child Neurology Society
2016 Volume.24 No. 3 p.143 ~ p.148
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Can be Clinical Outcomes of Pediatric Acute Encephalitis Predicted within 24 hr in Emergency Department?
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Song Ji-Yeon
Nam Sang-Ook
Kim Young-Mi
Yeon Gyu-Min
Lee Yoon-Jin
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Abstract
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Purpose: To evaluate the risk and clinical outcome indicators of pediatric acute encephalitis within 24 hour in the emergency department.
Methods: The authors retrospectively reviewed the medical charts of children admitted to a tertiary center with the diagnosis of acute encephalitis between 2009 and 2013. Three objectively-defined groups were identified according to clinical outcomes during hospitalization and discharge: (A) favorable outcomes with nearly complete recovery; (B) unfavorable outcomes with cognitive and/or motor deficit or neurological complication; (C) especially, progression to the epilepsy among children of group B.
Results: 128 children met the inclusion criteria (89 in group A, 39 in group B, and 26 in group C). The difference among the groups A, B and C respectively was in age (5.6±4.6, 6.8±5.0 and 7.5±5.3 years, P=0.042 [A vs C]). The most common presenting symptoms were fever (79.7%), decreased mentality (68.0%), and seizures (60.2%). Status epilepticus (SE, >5 min) (38.5%, 38.5% vs 12.4%, P<0.001) and relapse seizures after first 24 hr (51.3%, 61.5% vs 2.2%, P<0.001) were more frequent in group B and C than in group A. Continuous diffuse slowing (74.4%, 76.9% vs 51.7%, P=0.017) and epileptiform discharges (30.8%, 34.6% vs 10.1%, P=0.004) on electroencephalogram (EEG) were significantly often in group B and C than in group A. Patients of group B and C (20.5% and 19.2%, P<0.001) had significantly higher incidence of the brain edema on initial brain MRI than them of group A (5.6%).
Conclusion: SE, relapse seizures, diffuse slowing on EEG, and brain edema may suggest of the unfavorable outcomes in children of acute encephalitis.
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KEYWORD
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Encephalitis, Outcome, Risk, Child
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