Risk factors for secondary epilepsy in children with viral encephalitis.

OBJECTIVE

To investigate the clinical manifestations of secondary epilepsy (EP) in children with viral encephalitis and to identify any associated risk factors.

METHODS

A retrospective analysis was conducted on 130 children with viral encephalitis treated at Lu'an People's Hospital Affiliated with Anhui Medical University between December 2021 and October 2024. Of these, 36 children who developed secondary EP were classified as the EP group, and 94 children without secondary EP were categorized as the non-EP group. The overall incidence of secondary EP, clinical symptoms, cerebrospinal fluid (CSF) indices, and electroencephalogram (EEG) findings were compared between the groups. Multivariate logistic regression analysis was employed to identify independent risk factors for the development of secondary EP.

RESULTS

Of the 130 children with viral encephalitis, 36 (27.69%) developed secondary EP. Among them, 10 children (27.78%) had self-limited generalized EP, and 26 children (72.22%) had self-limited focal EP. Status epilepticus occurred in 7/36 cases (19.44%), but not in the other 29/36 cases (80.56%). No notable differences were observed in fever, headache, drowsiness, and coma between the EP group and non-EP group (>0.05). However, vomiting and coma were significantly more frequent in the EP group (<0.05). Abnormal EEG findings were also more prevalent in the EP group compared to the non-EP group (<0.05). Logistic regression analysis identified non-use of antiepileptic drugs (=0.039; CI: 0.181-0.958), elevated white blood cell count in CSF (=0.006; CI: 1.028-1.185), and moderate to severe abnormal EEG results (=0.041; CI: 1.035-5.41) as independent risk factors for the occurrence of secondary EP in children with viral encephalitis.

CONCLUSION

The incidence of secondary EP in children with viral encephalitis is relatively high. Non-use of antiepileptic drugs, elevated white blood cell count in the CSF, and moderate to severe abnormal EEG results were independent risk factors for the occurrence of secondary EP in children with viral encephalitis.