Clinical Analysis Of Viral Postencephalitis Epilepsy In Children

Objective: To analyze the clinical characteristics of viral encephalitis in children,to explore the risk factors for the development of postencephalitic epilepsy(PE).Through the visit understand the prognosis of postencephalitic epilepsy(PE)and compare the children with postencephalitic epilepsy(PE)in different age groups.Provided clinical basis for the future treatment.Methods: We conducted a retrospective review of patients diagnosed with viral encephalitis and meet the requirements of this study at Children’s Hospital of Soochow University,between January 2011 and December 2014.By follow-up,children were categorized into two groups based on the presence or absence of PE.Univariate and Multivariate logistic regression analysis was used to analyze factors associated with PE,and comparative analysis of clinical features and prognosis in different age children with postencephalitic epilepsy(PE).Results: 126 cases were enrolled in this experiment,of which 78 cases(61.9%)were younger than 4 years old,48 cases(38.1%)were older than 4 years in children,77 cases were male and 49 cases were female children.There were 104 cases(82.5%)of children with epileptic seizures in the acute stage of encephalitis.Of the 104 children,47(45.2%)had recurrent seizures,33(31.7%)were status epilepticus and 24(23.1%)had single seizures.According to the classification of the episodes,generalized seizures 36(34.6%),focal secondarily generalized seizures epilepsy 34(32.7%),simple partial seizures 20(19.2%),complicated partial seizures 14(13.5%).In the acute phase of encephalitis mental disorders 19 cases,focal neurological changes 42 cases.EEG examination in normal32(45.1%),epileptiform discharge 18(25.4%),non-epileptiform discharges 21(29.5%).Imaging examination in normal 56(52.8%),involved in the temporal lobe or parietal lobe 21(19.8%),involved in the frontal lobe 10(9.4%).In the recovery period of encephalitis the development of postencephalitic epilepsy(PE)in children was present in41 cases(32.5%),less than 4 years old children 19 cases,older than 4 years old children 22 cases.After multiple regression analysis,the risk factors for postencephalitic epilepsy(PE)in children were age,days of hospital stay,status epilepticus,acute epileptic seizures(P<0.05).Among the postencephalitic epilepsy(PE)in children,29(70.7%)with antiepileptic drugs had no seizures or had free use of antiepileptic drugs,7(17.1%)still had seizures after using antiepileptic drugs for two years,but not intractable epilepsy,5(12.2%)developed intractable epilepsy or complicated multiple system damage.Conclusions: The occurrence of coma,imaging cumulative temporal lobe or parietal lobe,EEG epileptiform discharge in the acute phase of viral encephalitis were associated with postencephalitic epilepsy(PE).The prolonged hospitalization,epileptic seizures,status epilepticus in the acute phase of viral encephalitis were the risk factors of postencephalitic epilepsy(PE).In children with epilepsy after viral encephalitis,children younger than 4 years of age were hospitalized longer than those with age ≥ 4 years old,the lesion is more likely to involve the frontal lobe.Viral postencephalitic epilepsy(PE)in children with active antiepileptic drug treatment,most of the prognosis is good,rarely developed into intractable epilepsy.