Pöyhönen Heidi, Setänen Sirkku, Isaksson Nea, Nyman Mikko, Nyman Anna, Peltola Ville, Lähdesmäki Tuire
Department of Pediatric Neurology, Turku University Hospital, Turku, Finland.
Departments of Pediatrics and Pediatric Neurology, University of Turku, Turku, Finland.
Front Pediatr. 2021 Apr 6;9:646684. doi: 10.3389/fped.2021.646684. eCollection 2021.
Children with encephalitis have increased risk for long-term neurological sequelae. We investigated minor neurological dysfunction (MND) and cognitive performance as a measurement for long-term outcome of encephalitis in childhood. Children with encephalitis ( = 98) treated in Turku University Hospital during the years 1995-2016 were retrospectively identified. We included the patients without severe developmental delay before the encephalitis and without recorded neurological disability caused by encephalitis. MND was assessed using the Touwen examination. Age-appropriate Wechsler Intelligence Scale was used to determine the full-scale intelligence quotient (IQ). Residual symptoms in everyday life were evaluated using a questionnaire. Forty-two subjects participated in the study and returned the questionnaire regarding residual symptoms. The median age was 4.3 years at the time of encephalitis, and 11.3 years at the time of the Touwen examination ( = 41) and the cognitive assessment ( = 38). The Touwen examination indicated MND in 29 of 41 participants (71%; simple MND in 16 and complex MND in 13 patients). The median full-scale IQ was lower in participants with MND compared with participants without MND (98 vs. 110, = 0.02). Participants with IQ < 85 ( = 5) had lower median age at acute encephalitis compared to participants with IQ ≥ 85 ( = 33) (1.8 vs. 5.3 years, = 0.03). Problems in daily performance were reported in participant with MND ( = 0.2) and low full-scale IQ ( = 0.008). The prevalence of MND was high and it was related to lower cognitive performance after childhood encephalitis. Younger age at acute encephalitis was a risk factor for lower cognitive performance.
患脑炎的儿童出现长期神经后遗症的风险增加。我们研究了轻度神经功能障碍(MND)和认知表现,以此作为儿童期脑炎长期预后的一项衡量指标。对1995年至2016年期间在图尔库大学医院接受治疗的98例脑炎患儿进行了回顾性研究。我们纳入了脑炎发作前无严重发育迟缓且无因脑炎导致的神经残疾记录的患者。使用图温检查法评估MND。采用适合相应年龄的韦氏智力量表来确定全量表智商(IQ)。使用问卷评估日常生活中的残留症状。42名受试者参与了研究并返回了有关残留症状的问卷。脑炎发作时的中位年龄为4.3岁,在进行图温检查(n = 41)和认知评估(n = 38)时的年龄为11.3岁。图温检查表明,41名参与者中有29名存在MND(71%;16例为单纯性MND,13例为复杂性MND)。与无MND的参与者相比,有MND的参与者全量表智商中位数较低(分别为98和110,P = 0.02)。智商<85的参与者(n = 5)在急性脑炎时的中位年龄低于智商≥85的参与者(n = 33)(分别为1.8岁和5.3岁,P = 0.03)。有MND的参与者(P = 0.2)和全量表智商较低的参与者(P = 0.008)报告了日常表现方面的问题。MND的患病率较高,且与儿童期脑炎后的认知表现较低有关。急性脑炎时年龄较小是认知表现较低的一个危险因素。