Clinical,EEG And MRI/CT Analysis Of Children With Epilepsy Secondary To Viral Encephalitis

Background and ObjectiveIntracranial infection is an important cause of seizures and acquired epilepsy.Viral encephalitis(VE),as one of the intracranial infections,seriously endangers children's health.The mechanism of acute and delayed seizures in VE remains unclear.Whether long-term anti-epileptic drugs are required after the acute phase,and what factors can predict the risk of later secondary epilepsy are not completely clear.Many studies have been done on the age of onset of viral encephalitis,status epilepticus(SE),disturbance of consciousness,focal neurological dysfunction,abnormalities of electroencephalogram(EEG)and imaging cortical involvement,and the relevant risk factors have been obtained.However,the following points are worth considering:1.EEG and imaging findings in the acute phase of encephalitis vary according to the time of execution;2.EEG slow wave activity is affected by different age groups,and sometimes it is difficult to distinguish from EEG after brain injury;3.The subcortical structures are closely related to the epilepsy networks,and focal seizures can originate from subcortical structures.Can simple subcortical involvement be a risk factor for postoperative epilepsy(PEE)?Neuroimaging and EEG respectively judge brain damage from the anatomical morphology and functional state of the brain.The combination of the two is of great value to the diagnosis,assessment and prognosis of VE.Starting from the above problems,the clinical manifestations,EEG and neuroimaging data of VE are analyzed in children of the same age during the first month of onset in this study.MethodsA total of 136 children diagnosed in The Third Clinical College of Zhengzhou University during the period 2012.01?2019.01 are selected.A total of 34 children which were diagnosed as PEE,are observation group.102 children with viral encephalitis,at the same time period and age,who were followed up for?6 months without secondary epilepsy(no-PEE)are selected as the control group.The EEG and imaging examinations were completed in the acute phase of VE.Clinical data were collected and followed up to find out whether the children had seizures,the number of seizures and the development.Using SPSS21.0 software to analysis,Univariate chi-square analysis and Multivariate logistic regression analysis,Using ?=0.05 as the test standard,the difference of P<0.05 is statistically significant.Results1.Between the two groups,EEG epileptic discharge(P<0.001),widely or diffuse slow activity(P<0.001),neuroimaging simple cortical involvement(P=0.023),cortical and subcortical involvement(P<0.001),thalamus-basal ganglia involvement(P=0.001),SE(P<0.001),coma(P<0.001)and seizures?2 times(P<0.001)in the acute stage of VE,the differences in univariate analysis are statistically significant(P<0.05).2.Between the two groups,EEG epileptic discharge(P=0.001),imaging cortical and subcortical involvement(P<0.001),SE(P=0.027),seizures?2 times(P=0.005)and coma(P=0.004)in the acute phase of VE,the differences of multivariate logistic regression analysis are statistically significant(P<0.05),which are risk factors for PEE.3.There is significant difference in mental retardation between the two groups during the follow-up period(P<0.001).Conclusions1.EEG epileptic discharge,neuroimaging simultaneous cortical and subcortical involvement,recurrent epileptic seizures,SE and coma in the acute phase of viral encephalitis are risk factors of PEE.2.PEE children often have backward mental development in the long term,so strict follow-up,systematic management and regular treatment should be given.