Neurological prognostic factors for human herpes virus 6/7-associated acute encephalopathy in children: A single-center study.

Autor: Watanabe Y; Children's Medical Center, Yokohama City University Medical Center, Yokohama, Japan. Electronic address: yoshi_w@yokohama-cu.ac.jp., Odaka M; Children's Medical Center, Yokohama City University Medical Center, Yokohama, Japan., Motoi H; Children's Medical Center, Yokohama City University Medical Center, Yokohama, Japan., Oyama Y; Children's Medical Center, Yokohama City University Medical Center, Yokohama, Japan., Shiga K; Children's Medical Center, Yokohama City University Medical Center, Yokohama, Japan., Ito S; Department of Pediatrics, Graduate School of Medicine, Yokohama City University, Yokohama, Japan.
Jazyk: angličtina
Zdroj: Brain & development [Brain Dev] 2023 Feb; Vol. 45 (2), pp. 102-109. Date of Electronic Publication: 2022 Oct 26.
DOI: 10.1016/j.braindev.2022.10.005
Abstrakt: Aim: To identify prognostic factors for severe neurological sequelae and epileptic seizures in children with human herpes virus (HHV) 6/7-associated acute encephalopathy (AE).
Methods: We retrospectively studied pediatric cases of HHV6/7-associated AE between April 2011 and March 2021. Neurological sequelae were assessed using the Pediatric Cerebral Performance Category scale (PCPC) and the presence of epileptic seizures 1 year after onset. We investigated the prognostic factors between the non-severe sequelae group (PCPC scores ≤ 2) and severe sequelae group (PCPC scores ≥ 3) in patients without severe neurological complications before onset.
Results: Forty patients, ranging from 4 to 95 months old, were included. AE with biphasic seizures and late reduced diffusion were the most common types of encephalopathy (n = 28). Among the 36 patients evaluated neurological sequelae, 17, nine, eight, and two were categorized as PCPC 1, 2, 3 and 4, respectively. Epileptic seizures were observed in nine patients. In the severe sequelae group, significantly more cases with coma in the acute phase and thalamic lesions on MRI and higher serum aspartate aminotransferase, alanine aminotransferase (ALT), and lactate dehydrogenase levels were observed. Multivariate analysis showed a significant between-group difference in the rate of coma (p = 0.0405). Patients with epileptic seizures had a higher rate of coma and thalamic lesions and higher serum ALT and urinary beta 2-microglobulin levels, but there was no significant difference in the multivariate analysis.
Conclusions: In HHV6/7-associated AE, coma was a significant prognostic factor for severe neurological sequelae.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2022 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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