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Pediatric encephalitis

Murat Sütçü, Hacer Aktürk, Sezen Gülümser-Şişko, Manolya Acar, Oğuz Bülent Erol, Ayper Somer, Bilge Bilgiç, Nuran Salman
Sütçü M, Aktürk H, Gülümser-Şişko S, Acar M, Erol OB, Somer A, Bilgiç B, Salman N. Granulomatous amebic encephalitis caused by Acanthamoeba in an immuncompetent child. Turk J Pediatr 2018; 60: 340-343. Acanthamoeba may lead to granulomatous amebic encephalitis (GAE) with high mortality rates generally in patients with immunosupression and/or chronic disease. Here, we present a rare GAE case, who was a previously healthy child. A Georgian 9 year old boy presented with focal seizure on his left arm and confusion...
2018: Turkish Journal of Pediatrics
A Michev, P Musso, T Foiadelli, C Trabatti, A Lozza, D Franciotta, A M Simoncelli, S Savasta
Bickerstaff Brainstem Encephalitis (BBE) is a rare autoimmune encephalitis, characterized by acute ophthalmoplegia, ataxia and altered state of consciousness. Together with Guillan-Barrè Syndrome (GBS) and Miller-Fisher Syndrome, it forms a spectrum of post-infectious demyelinating diseases. Overlapping forms between BBE and GBS (BBE/GBS) are described in patients with lower limbs weakness and typical signs of BBE, suggesting a combined involvement of Central and Peripheral Nervous System (PNS), but only few reported cases are focused on pediatric population...
November 20, 2018: European Journal of Paediatric Neurology: EJPN
Salvatore Savasta, Francesca Rovida, Thomas Foiadelli, Anna Maria Campana, Elena Percivalle, Gian Luigi Marseglia, Fausto Baldanti
BACKGROUND: West Nile virus (WNV) is a mosquito-borne RNA virus belonging to the Flaviviridae family. Symptomatic infection happens in only about 20% of the cases, while WNV neuroinvasive disease (WNND) is rare and accounts for less than 1%. There is insufficient information about natural history and clinical course in children, because underdiagnosis is common, and reports are scarce. On the other hand, Europe has seen a dramatic increase of WNV infections in the last decades, and the Po valley itself, in Northern Italy, has become an endemic region since 2013...
November 20, 2018: Italian Journal of Pediatrics
Joan M Balada-Llasat, Ning Rosenthal, Rodrigo Hasbun, Louise Zimmer, Samuel Bozzette, Steven Duff, Jessica Chung, Christine C Ginocchio
A retrospective cohort study design was used to assess the use and costs of diagnostic tests, medication, and total hospitalization costs for pediatric patients with suspected meningitis/encephalitis who received a lumbar puncture (LP) procedure. Related costs were calculated by timing of LP performed and infectious etiology for infants (<1 year) and children (1-17 years). A total of 3030 infants and 3635 children with suspected ME diagnosed between 2011 and 2014 were included in the study. The mean hospitalization cost for infants and children was $12,759 and $11,119, respectively, with medication and laboratory test costs of $834 and $1771 for infants and $825 and $855 for children, respectively...
October 27, 2018: Diagnostic Microbiology and Infectious Disease
Brian E Dawes, Junling Gao, Colm Atkins, Jacob T Nelson, Kendra Johnson, Ping Wu, Alexander N Freiberg
BACKGROUND: La Crosse virus (LACV) causes pediatric encephalitis in the USA. LACV induces severe inflammation in the central nervous system, but the recruitment of inflammatory cells is poorly understood. A deeper understanding of LACV-induced neural pathology is needed in order to develop treatment options. However, there is a severe limitation of relevant human neuronal cell models of LACV infection. METHODS: We utilized human neural stem cell (hNSC)-derived neuron/astrocyte co-cultures to study LACV infection in disease-relevant primary cells...
November 15, 2018: Journal of Neuroinflammation
Elisa Cainelli, Margherita Nosadini, Stefano Sartori, Agnese Suppiej
Objective: Anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis is a severe, but treatable, autoimmune disorder, characterized by autoantibodies causing hypofunction of blocking NMDA receptors leading to a unique constellation of cognitive, motor, and psychiatric symptoms. Neuropsychological and psychopathological outcome has not been fully explored, particularly in children. Aim of this study was to investigate pediatric anti-NMDAR encephalitis as a model of impairment of the complex frontal-subcortical circuits who are implicated in several of the childhood neuropsychiatric disorders...
November 12, 2018: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
Dong Liu, Xin Wang, Yisong Wang, Peigang Wang, Dongying Fan, Sichang Chen, Yuguang Guan, Tianfu Li, Jing An, Guoming Luan
Rasmussen's encephalitis (RE) is a rare pediatric neurological disorder, and the exact etiology is not clear. Viral infection may be involved in the pathogenesis of RE, but conflicting results have reported. In this study, we evaluated the expression of both Epstein-Barr virus (EBV) and human herpes virus (HHV) 6 antigens in brain sections from 30 patients with RE and 16 control individuals by immunohistochemistry. In the RE group, EBV and HHV6 antigens were detected in 56.7% (17/30) and 50% (15/30) of individuals, respectively...
October 2018: Virologica Sinica
Kei Wong, Sophia Sequeira, Kirsten Bechtel
Pediatric bilateral facial nerve paralysis (FNP) is a rare condition, representing less than 2% of all cases of FNP. The differential diagnosis of FNP is extensive (ranging from infectious, traumatic, neurologic, to idiopathic) and often can present as a diagnostic challenge. In contrast to unilateral presentation, bilateral FNP presents as a manifestation of serious systemic conditions, including meningitis (infectious and neoplastic), brain stem encephalitis, Guillain-Barre syndrome, sarcoidosis, Lyme disease, human immunodeficiency virus infection, leukemia, and vasculitis...
October 25, 2018: Pediatric Emergency Care
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...
October 16, 2018: Proceedings of the National Academy of Sciences of the United States of America
Jonathan D Santoro, Christopher C Hemond
BACKGROUND: Human herpesvirus 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 institutions 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...
January 2019: 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...
September 2018: Pediatric Neurology
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