Fritsch Peter, Gruber-Sedlmayr Ursula, Pansi Heike, Zöhrer Bettina, Mutz Ingomar, Spork Dietmar, Zenz Werner
Department of General Paediatrics, Medical University of Graz, Austria.
Acta Paediatr. 2008 May;97(5):535-8. doi: 10.1111/j.1651-2227.2008.00763.x.
Tick-borne encephalitis in children appears to be more benign than in adults and shows also a more favourable outcome. Only some authors report of sequelae like paralysis, paresis or seizures and behavioural abnormalities. The aim was to describe the clinical features of tick-borne encephalitis in children with special attention to sequelae and to review the literature.
Retrospective review of all charts of children with serologically confirmed tick-borne encephalitis hospitalised in Styria between 1981 and 2005.
One hundred sixteen children were diagnosed with tick-borne encephalitis. Ninety-two children (79.3%) developed meningitis and 24 (20.7%) meningoencephalitis. Eleven patients with meningoencephalitis showed somnolence, 5 confusion, 5 tremors, 2 facial palsy, 1 ataxia, 1 epileptic seizure and 1 hemi paresis. Seven patients had to be admitted to the intensive care unit. Two children (1.7%) developed long time neurological sequelae: one epileptic seizure with requirement of antiepileptic therapy and one left-sided hemi paresis. One hundred twelve children had been not and 3 incompletely vaccinated against tick-borne encephalitis. Only one child had been fully vaccinated according to the Austrian vaccination schedule.
Our study provides further evidence that tick-borne encephalitis in children has a substantial morbidity and in single cases severe long-time neurological sequelae are observed.
儿童蜱传脑炎似乎比成人的病情更为良性,且预后也更佳。仅有部分作者报告了诸如瘫痪、轻瘫、癫痫发作及行为异常等后遗症。本研究旨在描述儿童蜱传脑炎的临床特征,尤其关注后遗症,并对相关文献进行综述。
回顾性分析1981年至2005年间在施蒂里亚州住院治疗且血清学确诊为蜱传脑炎的所有儿童病历。
116名儿童被诊断为蜱传脑炎。92名儿童(79.3%)发生脑膜炎,24名(20.7%)发生脑膜脑炎。11名脑膜脑炎患者出现嗜睡,5名出现意识模糊,5名出现震颤,2名出现面瘫,1名出现共济失调,1名出现癫痫发作,1名出现偏瘫。7名患者需入住重症监护病房。2名儿童(1.7%)出现长期神经后遗症:1名癫痫发作需接受抗癫痫治疗,1名左侧偏瘫。112名儿童未接种或未完全接种蜱传脑炎疫苗,仅1名儿童按照奥地利疫苗接种计划完成了全程接种。
我们的研究进一步证明,儿童蜱传脑炎具有较高的发病率,个别病例会出现严重的长期神经后遗症。