Lin Chien-Heng, Lin Wei-De, Chou I-Ching, Lee Inn-Chi, Hong Syuan-Yu
Division of Pediatrics Pulmonology, China Medical University, Children's Hospital, Taichung, Taiwan.
Department of Biomedical Imaging and Radiological Science, China Medical University, Taichung, Taiwan.
Front Neurol. 2019 May 15;10:528. doi: 10.3389/fneur.2019.00528. eCollection 2019.
Central nervous system (CNS) infection in childhood can lead to neurological sequelae, including epilepsy, and neurodevelopmental disorders, such as attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). This study investigated the association of etiologically diagnosed childhood brain infections with the subsequent risks of epilepsy and neurodevelopmental disorders. We retrospectively analyzed the data of children aged <18 years who had definite brain infections with positive cerebrospinal fluid cultures from January 1, 2005, to December 31, 2017. These patients were followed to evaluate the risks of epilepsy and neurodevelopmental disease (ADHD and ASD) after brain infections (group 1) in comparison with the risks in those without brain infections (group 2). A total of 145 patients with an average age of 41.2 months were included in group 1. accounted for the majority of infections, followed by group B , and herpes simplex virus. A total of 292 patients with an average age of 44.8 months were included in group 2. The 12-year risk of epilepsy in group 1 was 10.7 (95% confidence interval [CI], 2.30-49; < 0.01). Compared with group 2 (reference), the risk of ASD in the age interval of 2-5 years in group 1 was 21.3 (95% CI, 1.33-341.4; = 0.03). The incidence of ADHD in group 1 was not significantly higher than that in group 2. This study identified the common etiological causes of brain infections in Taiwanese children. The highest-risk neurodevelopmental sequelae associated with brain infections was epilepsy. Children who had a diagnosis of brain infection (specially Enterovirus) should be followed since they are at greater risk of developing epilepsy and ASD.
儿童中枢神经系统(CNS)感染可导致神经后遗症,包括癫痫,以及神经发育障碍,如注意力缺陷多动障碍(ADHD)和自闭症谱系障碍(ASD)。本研究调查了病因明确的儿童脑部感染与随后发生癫痫和神经发育障碍风险之间的关联。我们回顾性分析了2005年1月1日至2017年12月31日期间年龄小于18岁、脑脊液培养阳性且确诊为脑部感染的儿童的数据。对这些患者进行随访,以评估脑部感染后(第1组)发生癫痫和神经发育疾病(ADHD和ASD)的风险,并与未发生脑部感染的患者(第2组)的风险进行比较。第1组共纳入145例平均年龄为41.2个月的患者。肠道病毒感染占大多数,其次是B组病毒和单纯疱疹病毒。第2组共纳入292例平均年龄为44.8个月的患者。第1组12年癫痫风险为10.7(95%置信区间[CI],2.30 - 49;P < 0.01)。与第2组(参照组)相比,第1组2至5岁年龄段患ASD的风险为21.3(95%CI,1.33 - 341.4;P = 0.03)。第1组ADHD的发病率显著高于第2组。本研究确定了台湾儿童脑部感染的常见病因。与脑部感染相关的最高风险神经发育后遗症是癫痫。确诊为脑部感染(特别是肠道病毒感染)的儿童应进行随访,因为他们发生癫痫和ASD的风险更高。