Clinical Analysis Of Postencephalitis Epilepsy In Children And Adults Patients

Objective: To describe the epidemiological features, clinical characteristics, outcomes, and predictors of postencephalitic epilepsy(PE) and a comparison of clinical characteristics, using antiepileptic drugs(AEDs) and prognosis in children and adults with postencephalitic epilepsy(PE) in acute encephalitis.Methods: We conducted a retrospective review of patients diagnosed with acute encephalitis at the First Affiliated Hospital and Children’s Hospital of Soochow University, between January 2010 and December 2014.The patients were categorized into two groups based on the presence or absence of PE at last follow-up. Univariate and Multivariate logistic regression analysis was used to analyze factors associated with PE, and comparative analysis of clinical features and prognosis after using AEDs in children and adults with postencephalitic epilepsy(PE)Results: We identified 186 consecutive patients(88 [47.3%] adults and 98 [53.7%]children). During hospitalization, seizures were seen in patients with acute encephalitis, adults 65,children 57,seizures on presentation were most frequently generalized and focal secondarily generalized epilepsy, single seizures 35(28.7%),recurrent seizures 64(52.4%), status epilepticus 23(18.9%).Normalities were found in 55.5% of patients who had MRI data, affected Unilateral lateralization 24(17.5%),affected Bilateral lateralization38(27.0%),and involvement of the temporal lobe 21, frontal lobe 10, parietal lobe 15,and cortical 9. Diffuse slow waves were seen in 46 patients, focal slowing was present in 39 patents, Interictal epileptiform discharges(IEDs) were seen in 20 patients. PE was present in 59 patients(31.7%),adults 34 and children 25. On multivariate regression analysis, the factors associated with PE were days before admission, status epilepticus, focal secondarily generalized epilepsy(P<0.05).76.2% Patients with PE have favorable outcome; and 20.3% patients have developed intractable postencephalitic epilepsy. A comparison of factors in adults and children with PE, adults with PE have more focal slowing(48.3%) in EEG compared with the children(13.3%)(P=0.022),however children with PE have more IEDs in EEG compared with the adults(P=0.028),Neurological deterioration was more in children on admission compared with the adults(P=0.01).Conclusions: Days before admission, the presence of seizures during hospitalization, focal secondarily generalized epilepsy are the strongest predictors of the development of PE. Although in some patients PE may be refractory to therapy, this complication is more easily treatable and compatible with good recovery of function. PE in children are more likely to develop neurological deterioration, IEDs in EEG compared with adults. However, PE in adults are more likely to appear focal slowing in EEG.