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Pediatric encephalitis

Gajanan N Sapkal, Pradeep M Sawant, Devendra T Mourya
Introduction: In recent years, the Chandipura virus (CHPV) has emerged as an encephalitic pathogen and found associated with a number of outbreaks in different parts of India. Children under 15 years of age are most susceptible to natural infection. CHPV is emerging as a significant encephalitis, causing virus in the Indian subcontinent. Severe outbreaks caused by the virus have been reported from several parts of India. Expalanation: In the recent past, the noticeable association of CHPV with pediatric sporadic encephalitis cases as well as a number of outbreaks in Andhra Pradesh (2004, 2005, 2007 and 2008), Gujarat in (2005, 2009-12) and Vidarbha region of Maharashtra (2007, 2009-12) have been documented...
2018: Open Virology Journal
Alison Wilkinson-Smith, Benjamin Greenberg, Audrey Keech
Autoimmune encephalitis is a rapidly evolving area of study in pediatric populations, and functional neurological symptom disorders are under-studied in children. Differential diagnosis among these disorders is challenging, but pediatric neuropsychologists are uniquely qualified to assist a multidisciplinary team. This case illustrates a young girl with suspected autoimmune encephalitis, whose symptoms were revealed to be primarily functional in nature. She was followed over the course of two years with neuropsychological evaluation and consultation...
September 28, 2018: Applied Neuropsychology. Child
Richard E Rosch, Sukhvir Wright, Gerald Cooray, Margarita Papadopoulou, Sushma Goyal, Ming Lim, Angela Vincent, A Louise Upton, Torsten Baldeweg, Karl J Friston
NMDA-receptor antibodies (NMDAR-Abs) cause an autoimmune encephalitis with a diverse range of EEG abnormalities. NMDAR-Abs are believed to disrupt receptor function, but how blocking this excitatory synaptic receptor can lead to paroxysmal EEG abnormalities-or even seizures-is poorly understood. Here we show that NMDAR-Abs change intrinsic cortical connections and neuronal population dynamics to alter the spectral composition of spontaneous EEG activity and predispose brain dynamics to paroxysmal abnormalities...
September 27, 2018: Proceedings of the National Academy of Sciences of the United States of America
Jonathan D Santoro, Christopher C Hemond
BACKGROUND: Human herpes virus 6 (HHV6) is a cause of post-transplant acute limbic encephalitis (PALE). Seizures are associated with this disorder yet no predictive biomarkers have been identified. The objective of this study was to evaluate lab and neurodiagnostic biomarkers in patients with HHV6 associated PALE. METHODS: A retrospective chart review was performed at our institution between 2000 and 2017. Patients were identified through a clinical database. Inclusion criteria included: age less than 18 years, HHV6 (quantitative real-time PCR or meningoencephalitis panel) tested in CSF and serum...
September 26, 2018: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Etsuro Nanishi, Takayuki Hoshina, Masafumi Sanefuji, Ryo Kadoya, Katsuhiko Kitazawa, Yukie Arahata, Tetsuya Sato, Yoshimichi Hirayama, Katsuki Hirai, Masaaki Yanai, Kaori Nikaido, Akihiko Maeda, Hiroyuki Torisu, Kenji Okada, Yasunari Sakai, Shouichi Ohga
Background: Japanese encephalitis (JE) is the leading cause of viral encephalitis with high mortality and morbidity in Asia. In Japan, however, the active recommendation of JE vaccine was retracted in 2005 because of the potential risk of acute disseminated encephalomyelitis. We aimed to determine the recent incidence of childhood-onset JE after the domestic change of vaccination policy in Japan, and to analyze the clinical features of affected children. Methods: A retrospective nationwide survey was conducted for pediatric patients with JE in Japan from 1995 to 2015...
September 24, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Liana M Theroux, Howard P Goodkin, Kristen C Heinan, Mark Quigg, J Nicholas Brenton
Autoimmune encephalitis has been increasingly recognized within the pediatric population, and the number of implicated autoantibodies continues to grow. The identification of characteristic clinical and paraclinical features helps direct the evaluation and increases the likelihood of making a definitive diagnosis of a specific antibody-mediated encephalitis. The finding of extreme delta brush on electroencephalogram (EEG) has been suggested to serve as a clinical clue to the diagnosis of anti-NMDA-R encephalitis...
September 13, 2018: Multiple Sclerosis and related Disorders
Robert Steffen
Tick-borne encephalitis (TBE) vaccination recommendations for children residing in high-endemicity countries in Europe vary from universal recommendations to none at all. Such differences may result in uncertainty about the value of such prevention among public health authorities, healthcare professionals and parents. We conducted a systematic review of publications and data from the European Centres for Disease Prevention and Control focusing on the epidemiology, clinical characteristics, and outcomes of TBE in a pediatric population...
September 1, 2018: Ticks and Tick-borne Diseases
George Imataka, Takeshi Yamaguchi, Junpei Ishii, Kei Ogino, Kentaro Okamoto, Takashi Tsuchioka, Shigemi Yoshihara
A case of mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) in a female child who developed bacterial translocation from a congenital portal vein hypoplasia is reported. The patient was diagnosed as having portal hypertension after examinations and laboratory results showing splenomegaly and thrombocytopenia at the age of 1 year. The patient required three endoscopic variceal ligation (EVL) surgeries before the age of 9 due to development of multiple esophageal varices. After the second and third EVL procedures, she developed septicemia, possibly due to bacterial translocation associated with the administration of general anesthesia...
October 2018: Experimental and Therapeutic Medicine
Tianhua Li, Ningning Qi, Xiaona Gao, Haili Yu
In this report, we summarize our experience of rescuing four children with severe type A H3N2 influenza from January to February 2017 in Weifang People's Hospital, Shandong Province, China for reference in clinical treatment. Two boys and two girls, ranging in age from 3 months to 6 years, with fever, cough, and asthma, were admitted to the pediatric intensive care unit. All children had severe pulmonary infection with respiratory distress. Three children had myocardial damage, two had liver damage, and one had encephalitis...
September 13, 2018: Journal of International Medical Research
Kavitha Kothur, Christopher Troedson, Richard Webster, Sushil Bandodkar, Stephanie Chu, Louise Wienholt, Alun Pope, Mark T Mackay, Russell C Dale
Aim To determine the role of inflammation in pediatric transient focal cerebral arteriopathy using cerebrospinal fluid cytokine/chemokines as biomarkers. Methods We measured 32 cytokine/chemokines in acute cerebrospinal fluid collected from children with stroke due to focal cerebral arteriopathy (n = 5) using multiplex immunoassay and compared with two patients with arterial ischemic stroke due to other causes (non-focal cerebral arteriopathy group, vertebral dissection, n = 1; cryptogenic, n = 1), pediatric encephalitis (n = 43), and non-inflammatory neurological disease controls (n = 20)...
September 13, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Anna Eichinger, Alexandra Hagen, Melanie Meyer-Bühn, Johannes Huebner
BACKGROUND: Sepsis-like illness with suspected meningitis or encephalitis is a common reason for using empiric antimicrobial therapy in infants and children. However, in cases of viral meningitis not covered by these antimicrobials, this management is ineffective and due to side effects potentially harmful. METHODS: A retrospective analysis of cerebrospinal fluid (CSF) multiplex PCRs (Biofire FilmArray® ) in children with clinical suspicion of meningitis, encephalitis or sepsis-like illness was performed over the period of 1 year...
September 5, 2018: Infection
Rachel L Randell, Ashley V Adams, Heather Van Mater
BACKGROUND: Autoimmune encephalitis can result in significant neurological and psychiatric morbidity and mortality in patients of all ages and often does not respond to standard therapies. Recent reports suggest efficacy of tocilizumab, a monoclonal antibody against interleukin 6, in refractory autoimmune encephalitis. RESULTS: We describe three children with refractory autoimmune encephalitis who experienced a robust, immediate clinical response following treatment with tocilizumab...
August 3, 2018: Pediatric Neurology
Kenji Iwai, Kiyoko Amo, Ichiro Kuki, Masataka Fukuoka, Kiyohiro Kim, Chiharu Yamairi, Masao Togawa
Sjögren syndrome (SS) is a systemic inflammatory and autoimmune disease characterized by systemic disorders of the exocrine glands, predominantly the salivary and lacrimal glands. Here, we report a 4-year-old boy who presented with the repetition of generalized tonic-clonic seizures for 1-2 min. Initially, he was diagnosed with idiopathic autoimmune encephalitis and was treated with steroids. He was eventually diagnosed with SS based on the examination results, such as inflammatory cell infiltration into the minor salivary glands and positive serum anti-SSA/Ro antibody...
August 28, 2018: Brain & Development
Joshua Nealon, Anne-Frieda Taurel, Sutee Yoksan, Annick Moureau, Matt Bonaparte, Luong Chan Quang, Maria R Capeding, Ari Prayitno, Sri Rezeki Hadinegoro, Danaya Chansinghakul, Alain Bouckenooghe
Japanese encephalitis virus (JEV) is a zoonotic, mosquito-borne flavivirus, distributed across Asia. Infections are mostly mild/asymptomatic but symptoms include neurological disorders, sequelae and fatalities. Data to inform control strategies are limited by incomplete case reporting. We used JEV serological data from a multi-country Asian dengue vaccine study in children aged 2-14 years to describe JEV endemicity by plaque reduction neutralization test (PRNT50). 1479 unvaccinated subjects were included. A minimal estimate of pediatric JEV seroprevalence in dengue-naïve individuals was 8...
August 28, 2018: Journal of Infectious Diseases
Shinichiro Goto, Nobuyuki Nosaka, Takashi Yorifuji, Tomoaki Wada, Yosuke Fujii, Masato Yashiro, Yosuke Washio, Kosei Hasegawa, Hirokazu Tsukahara, Tsuneo Morishima
We studied the etiology of pediatric acute encephalitis/encephalopathy (pAEE) using epidemiological data obtained from a nationwide survey in Japan. Two-step questionnaires were sent to the pediatric departments of hospitals throughout the country in 2007, querying the number of the cases during 2005-2006 as the first step, and asking for the details of clinical information as the second step. In all, 636 children with pAEE (age ≤ 15 years) were enrolled. For the known etiology of pAEE (63.5% of the total cases), 26 microbes and 2 clinical entities were listed, but the etiology of 36...
August 2018: Acta Medica Okayama
Melanie J Sekeres, Lily Riggs, Alexandra Decker, Cynthia B de Medeiros, Agnes Bacopulos, Jovanka Skocic, Kamila Szulc-Lerch, Eric Bouffet, Brian Levine, Cheryl L Grady, Donald J Mabbott, Sheena A Josselyn, Paul W Frankland
Medulloblastomas, the most common malignant brain tumor in children, are typically treated with radiotherapy. Refinement of this treatment has greatly improved survival rates in this patient population. However, radiotherapy also profoundly impacts the developing brain, and is, for example, associated with reduced hippocampal volume and blunted hippocampal neurogenesis. Such hippocampal (as well as extra-hippocampal) abnormalities likely contribute to cognitive impairments in this population. While several aspects of memory have been examined in this population, the impact of radiotherapy on autobiographical memory has not previously been evaluated...
August 20, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
Sean T O'Leary, James D Campbell, David W Kimberlin
The Advisory Committee on Immunization Practices (ACIP), a group of medical and public health experts, meets 3 times per year to develop recommendations for vaccine use in the United States. The group has 15 voting members, and each member's term is 4 years. ACIP members and Centers for Disease Control and Prevention staff discuss the epidemiology of vaccine-preventable diseases and vaccine research, effectiveness, safety data, and clinical trial results. Representatives from the American Academy of Pediatrics (J...
August 2, 2018: Journal of the Pediatric Infectious Diseases Society
Yang Sai, Xiao Zhang, Mei Feng, Jingwen Tang, Hongmei Liao, Lihong Tan
The aim of the present retrospective study was to investigate the diagnosis, treatment and prognosis of pediatric anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis. A total of 23 pediatric patients with anti-NMDAR encephalitis were included in the present study. The clinical data, laboratory test results, imaging examination, treatment outcomes, and follow-up records were reviewed and analyzed. A total of 8 patients exhibited prodromal symptoms, including fever, cough, and vomiting. Clinical symptoms included epilepsy, convulsions, ataxia, coma, dyskinesia, personal behavior change and hallucinations...
August 2018: Experimental and Therapeutic Medicine
Damla Hanalioğlu, Yasemin Özsürekci, Ayşe Büyükçam, Ayşe Gültekingil-Keser, Özlem Tekşam, Mehmet Ceyhan
Hanalioğlu D, Özsürekci Y, Büyükçam A, Gültekingil-Keser A, Tekşam Ö, Ceyhan M. Acute peripheral facial paralysis following varicella infection: An uncommon complication. Turk J Pediatr 2018; 60: 99-101. Chickenpox is caused by varicella zoster virus (VZV/HHV-3), which is one of the eight human herpes viruses. Although chickenpox has a good prognosis, neurologic complications including encephalitis, acute cerebellar ataxia, myelitis and meningitis may seldom be associated with the disease. Peripheral facial palsy (PFP) is an extremely rare complication in patients with chickenpox...
2018: Turkish Journal of Pediatrics
Natalia Moss, Christine L Petranovich, Lauren Parks, Andrea Sherwood
Anti-NMDAR autoimmune encephalitis is a rare neurological condition. Limited existing pediatric case studies have shown mild, but persisting, neuropsychological impairments. This report described neuropsychological functioning in two patients treated for anti-NMDAR autoimmune encephalitis. Patient A is a 16-year-old male (10 months after symptom onset) and Patient B is a 5-year-old female (45 months after symptom onset). Contrary to expectations, their cognitive profiles were largely intact, raising the possibility of minimal cognitive implications for some pediatric patients with this condition...
2018: Developmental Neuropsychology
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