Etiological associations and outcome predictors of acute electroencephalography in childhood encephalitis.
Clin Neurophysiol
; 127(10): 3217-24, 2016 10.
Article
in En
| MEDLINE
| ID: mdl-27521622
ABSTRACT
OBJECTIVES:
To examine EEG features in a retrospective 13-year cohort of children with encephalitis.METHODS:
354 EEGs from 119 patients during their admission were rated blind using a proforma with demonstrated inter-rater reliability (mean k=0.78). Patients belonged to 12 etiological groups that could be grouped into infectious and infection-associated (n=47), immune-mediated (n=36) and unknown (n=33). EEG features were analyzed between groups and for risk of abnormal Liverpool Outcome Score and drug resistant epilepsy (DRE) at last follow up.RESULTS:
86% children had an abnormal first EEG and 89% had at least one abnormal EEG. 55% had an abnormal outcome, and 13% had DRE after median follow-up of 7.3years (2.0-15.8years). Reactive background on first EEGs (9/11, p=0.04) and extreme spindles (4/11, p<0.001) distinguished patients with anti-N-Methyl-d-Aspartate Receptor encephalitis. Non-reactive EEG background (48% first EEGs) predicted abnormal outcome (OR 3.8, p<0.001). A shifting focal seizure pattern, seen in FIRES (4/5), anti-voltage gated potassium channel (2/3), Mycoplasma (1/10), other viral (1/10) and other unknown (1/28) encephalitis, was most predictive of DRE after multivariable analysis (OR 11.9, p<0.001).CONCLUSIONS:
Non-reactive EEG background and the presence of shifting focal seizures resembling migrating partial seizures of infancy are predictors of abnormal outcome and DRE respectively in childhood encephalitis.SIGNIFICANCE:
EEG is a sensitive but non-discriminatory marker of childhood encephalitis. We highlight the EEG features that predict abnormal outcome and DRE.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Electroencephalography
/
Encephalitis
Type of study:
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
Language:
En
Journal:
Clin Neurophysiol
Journal subject:
NEUROLOGIA
/
PSICOFISIOLOGIA
Year:
2016
Document type:
Article