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Acute Childhood Encephalitis

M Saitoh, K Kobayashi, I Ohmori, Y Tanaka, K Tanaka, T Inoue, A Horino, K Ohmura, A Kumakura, Y Takei, S Hirabayashi, M Kajimoto, T Uchida, S Yamazaki, T Shiihara, T Kumagai, M Kasai, H Terashima, M Kubota, M Mizuguchi
Febrile infection-related epilepsy syndrome (FIRES), or acute encephalitis with refractory, repetitive partial seizures (AERRPS), is an epileptic encephalopathy beginning with fever-mediated seizures. The etiology remains unclear. To elucidate the genetic background of FIRES/AERRPS (hereafter FIRES), we recruited 19 Japanese patients, genotyped polymorphisms of the IL1B, IL6, IL10, TNFA, IL1RN, SCN1A and SCN2A genes, and compared their frequency between the patients and controls. For IL1RN, the frequency of a variable number of tandem repeat (VNTR) allele, RN2, was significantly higher in the patients than in controls (p=0...
September 15, 2016: Journal of the Neurological Sciences
Shekeeb S Mohammad, Samantha M Soe, Sekhar C Pillai, Margherita Nosadini, Elizabeth H Barnes, Deepak Gill, Russell C Dale
OBJECTIVES: To examine EEG features in a retrospective 13-year cohort of children with encephalitis. METHODS: 354 EEGs from 119 patients during their admission were rated blind using a proforma with demonstrated inter-rater reliability (mean k=0.78). Patients belonged to 12 etiological groups that could be grouped into infectious and infection-associated (n=47), immune-mediated (n=36) and unknown (n=33). EEG features were analyzed between groups and for risk of abnormal Liverpool Outcome Score and drug resistant epilepsy (DRE) at last follow up...
October 2016: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Gulam Khandaker, Jenny Jung, Philip N Britton, Catherine King, J Kevin Yin, Cheryl A Jones
AIM: The long-term outcomes of childhood infective encephalitis are variable and not well quantified. We aimed to systematically review the literature and undertake meta-analyses on predetermined outcomes to address this knowledge gap and identify areas for future research. METHOD: We searched electronic databases, performed complementary reviews of references of fully extracted articles, and made contact with experts on infective encephalitis. Articles published up until April 2016 were selected for screening...
November 2016: Developmental Medicine and Child Neurology
J Nicholas Brenton, Howard P Goodkin
BACKGROUND: The differential diagnosis of encephalitis in childhood is vast, and evaluation for an etiology is often unrevealing. Encephalitis by way of autoimmunity has long been suspected, as in cases of acute disseminated encephalomyelitis; however, researchers have only recently reported evidence of antibody-mediated immune dysregulation resulting in clinical encephalitis. MAIN FINDINGS: These pathologic autoantibodies, aimed at specific neuronal targets, can result in a broad spectrum of symptoms including psychosis, catatonia, behavioral changes, memory loss, autonomic dysregulation, seizures, and abnormal movements...
July 2016: Pediatric Neurology
Åsa Fowler, Sofia Ygberg, Gordana Bogdanovic, Ronny Wickström
BACKGROUND: Tick-borne encephalitis (TBE) is a major cause of meningoencephalitis in children in endemic areas, and long-term residual problems are not uncommon. Currently, no predictive markers in the acute phase are available that identify children at risk of incomplete recovery. We measured cytokines, chemokines and markers of neuronal damage in cerebrospinal fluid (CSF) in children with TBE and central nervous system (CNS) involvement. METHODS: CSF from 37 children with TBE with CNS involvement was analyzed...
September 2016: Pediatric Infectious Disease Journal
Melissa Van Arsdall, Ikram Haque, Yuying Liu, J Marc Rhoads
Twenty years ago, there was profound, international interest in developing oral human, bovine, or chicken egg-derived immunoglobulin (Ig) for the prevention and nutritional treatment of childhood malnutrition and gastrointestinal disease, including acute diarrhea and necrotizing enterocolitis. Although such Ig products were shown to be effective, with both nutritional and antidiarrheal benefits, interest waned because of their cost and because of the perceived risk of bovine serum encephalitis (BSE). BSE is no longer considered a barrier to use of oral Ig, because the WHO has declared the United States to be BSE-free since the early 2000s...
May 2016: Advances in Nutrition
Camille Rérolle, Maxime Faisant, Thierry Lefrancq, Pauline Saint-Martin
We report the case of a 5-year-old boy who died from complications of rheumatic heart disease with atypical presentation. He was hospitalized for recent inflammatory and neurological symptoms. He was diagnosed with viral encephalitis. He died the day after he was discharged. The macroscopic autopsy findings were unremarkable. Histology revealed typical rheumatic heart disease. Neuropathology showed cerebral infarction due to an embolic event linked with the rheumatic valvulitis. The cause of death was determined as heart failure due to rheumatic heart disease secondary to an undiagnosed acute rheumatic fever...
May 2016: Journal of Forensic Sciences
Yeon Jin Jeon, Hyun Young Lee, In Ah Jung, Won-Kyoung Cho, Bin Cho, Byung-Kyu Suh
Cerebral salt-wasting syndrome (CSWS) is a rare disease characterized by a extracellular volume depletion and hyponatremia induced by marked natriuresis. It is mainly reported in patients who experience a central nervous system insult, such as cerebral hemorrhage or encephalitis. The syndrome of inappropriate antidiuretic hormone secretion is a main cause of severe hyponatremia after hematopoietic stem cell transplantation, whereas CSWS is rarely reported. We report 3 patients with childhood acute leukemia who developed CSWS with central nervous system complication after hematopoietic stem cell transplantation...
December 2015: Annals of Pediatric Endocrinology & Metabolism
Shuo Zhang, Juan Feng, Yifang Shi
Infection with Epstein-Barr virus (EBV) is very common and usually occurs in childhood or early adulthood. Encephalitis/encephalopathy is an uncommon but serious neurological complication of EBV. A case of EBV-associated encephalitis/encephalopathy with involvement of reversible widespread cortical and splenial lesions is presented herein. An 8-year-old Chinese girl who presented with fever and headache, followed by seizures and drowsiness, was admitted to the hospital. Magnetic resonance imaging revealed high signal intensities on diffusion-weighted imaging in widespread cortical and splenial lesions...
January 2016: International Journal of Infectious Diseases: IJID
Sekhar C Pillai, Shekeeb S Mohammad, Yael Hacohen, Esther Tantsis, Kristina Prelog, Elizabeth H Barnes, Deepak Gill, Ming J Lim, Fabienne Brilot, Angela Vincent, Russell C Dale
To define the risk factors for postencephalitic epilepsy (PE) and drug-resistant epilepsy (DRE) in childhood following infectious and autoimmune encephalitis, we included 147 acute encephalitis patients with a median follow-up of 7.3 years (range 2-15.8 years). PE was defined as the use of antiepileptic drugs (AEDs) for ≥24 months, and DRE was defined as the persistence of seizures despite ≥2 appropriate AEDs at final follow-up. PE and DRE were diagnosed in 31 (21%) and 15 (10%) of patients, respectively...
January 2016: Epilepsia
Manuela Zlamy, Edda Haberlandt, Jürgen Brunner, Ludwig Dozcy, Kevin Rostasy
We report the case of a 13-year-old girl who presented with fever, headache, nausea and pain behind the right ear. Cerebrospinal fluid (CSF; leukocytes 227/μL), electroencephalogram and cerebral magnetic resonance imaging were indicative of meningoencephalitis. Despite intensive therapy the general condition worsened and the patient was admitted to the intensive care unit. Serological analysis of CSF and serum indicated acute tick-borne encephalitis virus (TBEV) infection (IgG and IgM positive). TBEV infection has been reported after incomplete and complete vaccination...
January 2016: Pediatrics International: Official Journal of the Japan Pediatric Society
Philip N Britton, Lynette Khoury, Robert Booy, Nicholas Wood, Cheryl A Jones
OBJECTIVE: The clinical epidemiology of childhood encephalitis in Australia is inadequately understood. We aimed to describe recent trends in childhood encephalitis-related hospitalisation. STUDY DESIGN: We identified encephalitis-related hospital admissions (2000-2012) in national datasets among children ≤14 years using ICD encephalitis codes. We calculated hospitalisation rates and analysed trends by year, age, gender, location, indigenous status and aetiology...
January 2016: Archives of Disease in Childhood
C L Abad, N Safdar
Measles, or rubeola, is a highly infectious, acute viral illness of childhood that is considered eliminated in the USA but has reemerged in the past few years. Globally, an estimated 20 million cases of measles continue to occur, and it remains a leading cause of death among young children. It is rare in the USA and other first world countries, but numerous outbreaks have occurred in the USA recently, due to a combination of factors including poor vaccine coverage and importation of cases among travelers returning from endemic areas...
December 2015: Current Infectious Disease Reports
Susan Clarke, Robyn Richmond, Heather Worth, Rajendra Raj Wagle
BACKGROUND: Chronic Suppurative Otitis Media (CSOM) is the commonest cause of preventable deafness, affecting 164 million people worldwide, 90 % of whom live in low resource countries, such as Nepal. Simple, inexpensive treatment of acute otitis media can prevent the development of CSOM and its sequelae: deafness, abscess, encephalitis, and, rarely, death. CSOM is a disease of poverty and its social determinants: low parental education, overcrowding, poor hygiene and malnutrition. Previous studies have established economic, socio-cultural and geographic barriers to care seeking for childhood illness in the developing world and, in particular, in Nepal...
2015: BMC Ear, Nose, and Throat Disorders
Siba Prosad Paul, Emily Natasha Kirkham, Bethany Shirt
Febrile convulsion is characterised by convulsion associated with fever in an infant or child aged between six months and six years. The febrile illness causing the convulsion should not be secondary to an intracranial infection (meningitis or encephalitis) or acute electrolyte imbalance. Most cases of febrile convulsion are short lived and self-terminating. However, a few cases of prolonged febrile convulsion may need anticonvulsant medication to stop the seizure. Management is mainly symptomatic, although anticonvulsants may have a role in a small number of children with complex or recurrent febrile convulsion...
August 26, 2015: Nursing Standard
Neggy Rismanchi, Jeffrey J Gold, Shifteh Sattar, Carol Glaser, Heather Sheriff, James Proudfoot, Andrew Mower, Mark Nespeca, John R Crawford, Sonya G Wang
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...
September 2015: Pediatric Neurology
Nili Yanai Milshtein, Gideon Paret, Shimon Reif, Ora Halutz, Galia Grisaru-Soen
OBJECTIVES: The clinical characteristics, pathogens, and outcome were analyzed to investigate the etiology of acute pediatric encephalitis in 2 tertiary pediatric medical centers in Israel. METHODS: A retrospective study among children aged 1 month to 18 years hospitalized with the diagnosis of acute encephalitis between January 1999 and December 2009. Data on presenting symptoms, clinical findings, microbiological, virologic, electroencephalographic and neuroimaging studies, laboratory results, and hospital course were retrieved from the medical records and the computerized microbiology database...
February 2016: Pediatric Emergency Care
Hiroyuki Torisu, Toshiro Hara
Influenza-associated encephalopathy is a syndrome that chiefly manifests consciousness disturbance provoked by influenza. It is defined pathologically as acute neurological dysfunction that results from non-inflammatory brain edema. The clinical picture is so diverse that many clinical subtypes and multiple pathologies have been proposed to date. Influenza-associated encephalopathy is diagnosed and treated according to the disease guideline in Japan, which has improved the outcome of influenza-associated encephalopathy...
July 2015: Brain and Nerve, Shinkei Kenkyū No Shinpo
Yuji Ito, Jun Natsume, Hiroyuki Kidokoro, Naoko Ishihara, Yoshiteru Azuma, Takeshi Tsuji, Akihisa Okumura, Tetsuo Kubota, Naoki Ando, Shinji Saitoh, Kiyokuni Miura, Tamiko Negoro, Kazuyoshi Watanabe, Seiji Kojima
OBJECTIVE: The aim of this study was to clarify characteristics of post-encephalopathic epilepsy (PEE) in children after acute encephalopathy with biphasic seizures and late reduced diffusion (AESD), paying particular attention to precise diagnosis of seizure types. METHODS: Among 262 children with acute encephalopathy/encephalitis registered in a database of the Tokai Pediatric Neurology Society between 2005 and 2012, 44 were diagnosed with AESD according to the clinical course and magnetic resonance imaging (MRI) findings and were included in this study...
August 2015: Epilepsia
Patrick M Meyer Sauteur, Joyce Roodbol, Annette Hackenberg, Marie-Claire Y de Wit, Cornelis Vink, Christoph Berger, Enno Jacobs, Annemarie M C van Rossum, Bart C Jacobs
We report seven children with recent Mycoplasma pneumoniae infection and severe Guillain-Barré syndrome (GBS) that presented to two European medical centres from 1992 to 2012. Severe GBS was defined as the occurrence of respiratory failure, central nervous system (CNS) involvement, or death. Five children had GBS, one Bickerstaff brain stem encephalitis (BBE), and one acute-onset chronic inflammatory demyelinating polyneuropathy (A-CIDP). The five patients with severe GBS were derived from an original cohort of 66 children with GBS...
June 2015: Journal of the Peripheral Nervous System: JPNS
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