Neuroimaging and neurological outcome of children with acute encephalitis

Abstract

<p>Aim: To investigate the severity of acute phase magnetic resonance imaging (MRI) findings and severity of acute illness as risk factors for disability after recovery from encephalitis.</p><p>Method: Children with encephalitis (n = 98; median age 6 years 10 months, inter-quartile range 3 years–11 years 6 months; 59 males, 39 females) treated in Turku University Hospital during the years 1995 to 2016 were identified in this retrospec-tive cohort study. The acute phase (<2 months of symptom onset) brain MRIs were re-evaluated and classified based on the severity of neuroimaging finding by a neu-roradiologist. Neurological outcome at discharge, at short-term (<3 months from discharge) follow-up, and at long-term (>1 year from discharge) follow-up was as-sessed from medical records using the Glasgow Outcome Scale.<br></p><p>Results: Long-term recovery was poor in 24 of 82 (29%) children with follow-up data. Two children died, eight had severe disability, and 14 had moderate disability. Acute phase MRI was available for re-evaluation from 74 of 82 patients with follow-up data. The increasing severity of MRI findings was associated with need for ventilator ther-apy and with poor recovery.</p><p>Interpretation: The risk for poor recovery in paediatric encephalitis is high, and it is associated with the severity of MRI findings.</p>