Analysis Of Clinical Characteristics And Prognostic Factors Of 80 Patients With Viral Encephalitis

Background and PurposeViral encephalitis（VE）is the main cause of nervous system infection which can cause severe neuroinflammatory reaction,severe brain damage and even death.It is relatively difficult to make the early diagnosis.When the patient is diagnosed until his nervous symptoms have been obvious,the treatment effect is not as good as that started at the early stage,which may bring heavy economic burden to the family and neurological sequelae.The purpose of this research is to summarize the clinical data and characteristics of patients with viral encephalitis,and analyze the correlation of clinical characteristics and the prognosis,so doctors can make a reasonable evaluation of the patient and a correct judgment of disease prognosis,which is useful for doctor-patient communication and the decrease of medical disputes.The recognition of clinical characteristics is helpful for the early diagnosis,the reduction of medical cost,the sequelae and mortality.MethodsWe used the method of retrospective case analysis,selected 80 patients hospitalized in the First Affiliated Hospital of Harbin Medical University and Harbin Children’s Hospital from January 1^stof 2009 to December 31^stof 2019.All the patients had the definite diagnosis of VE.We collected the clinical data such as patients’general information,clinical symptoms,the changes of EEG（normal,mild,moderate,severe）and brain MRI image（mild,moderate,severe）,clinical prognosis（cure,sequelae of epileptic seizure or disturbance of consciousness）to investigate the correlation of all the above factors and the sequelae of VE with the statistical analysis methods of T-test,The chi-square test,the exact probability method and Logistic regression analysis.Results1.The total number of patients was 80,including 41 male patients（51.25%）and39 female patients（48.75%）.19 cases（23.75%）were attacked in spring,20 cases（25%）in summer,27 cases（33.75%）in autumn and 14 cases（17.5%）in winter.Among them 41 patients（51.25%）in the group discharged with the sequelae（epileptic seizure and/or disturbance of consciousness）,and 39 patients（48.75%）in the group discharged without the sequelae.EEG and MRI had significant difference between the two groups,with P value of<0.0001 and 0.0086 respectively.EEG and MRI were included in the multi-factor analysis,and the results showed that the EEG classification（P<0.0001,OR=9.487）and the MRI classification（P=0.0234,OR=2.582）were both associated with the sequelae.2.To compare the two groups of patients with or without the sequelae of epileptic seizure,the total number of patients was 80,including 58 patients（72.5%）of discharge without the sequelae of epileptic seizure and 22 patients（27.5%）with it.The results indicated that there was statistical difference between the two groups of seizures after one week of VE onset,EEG and MRI,with P value of<0.0001,0.0010and 0.0235,respectively.When the three factors were included in the multi-factor analysis,the results showed that the sequelae of epileptic seizure were related to the seizures after one week of VE onset（P<0.0001,OR=62.991）and EEG（P=0.0208,OR=4.626）.3.To compare the two groups of patients with or without the sequelae of disturbance of consciousness,the total number of patients was 80,including 56patients（70.00%）without the sequelae of disturbance of consciousness and 24patients（30.00%）with it.The results showed that there were significant differences of disturbance of consciousness at the onset of the disease and EEG classification between the two groups,with P value of 0.0004 and<0.0001,respectively.When the two factors were included in the multi-factor analysis,the results indicated that the disturbance of consciousness at VE onset（P=0.0006,OR=11.541）and EEG classification（P<0.0001,OR=8.893）were correlated with the sequelae of disturbance of consciousness.Conclusions1.The clinical characteristics of viral encephalitis in children investigated in this research are as follows:There is no significant gender difference in the incidence of male and female patients.Viral encephalitis is liable to occur in summer and autumn.Fever,seizures,and the disturbance of consciousness are the first main symptoms.2.The prognosis of viral encephalitis is associated with EEG and brain MRI abnormalities.3.The sequelae of epileptic seizure is correlated with epileptic seizures after one week of VE onset and EEG abnormalities but it is neither associated with epileptic seizures,conscious disturbance nor brain MRI image changes within one week of VE onset.4.The disturbance of consciousness after viral encephalitis is related to the disturbance of consciousness at VE onset and the abnormal EEG,but it is neither associated with epileptic seizures nor the change of brain MRI.