Analysis of Fulminant Cerebral Edema in Acute Pediatric Encephalitis

Shih Yun Lan, Jainn Jim Lin, Shao Hsuan Hsia, Huei Shyong Wang, Cheng Hsun Chiu, Kuang Lin Lin*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

19 Scopus citations

Abstract

Background Acute pediatric encephalitis with fulminant cerebral edema can rapidly become fatal or result in devastating neurological sequelae. Methods All cases coded with the discharge diagnosis of acute encephalitis between January 2000 and December 2010 were reviewed. Of the 1038 children with acute pediatric encephalitis, 25 were enrolled in our study with ages ranging from 5 months to 16 years. Results The major neurological symptoms included an altered level of consciousness (72%), vomiting (60%), and headache (48%). The onset of neurological symptoms to signs of brain herniation ranged from 0 days to 9 days. Nineteen (76%) patients had a seizure 24–48 hours prior to showing signs of fulminant cerebral edema, and 12 (48%) patients developed status epilepticus. Sixteen patients died, and no survivors returned to baseline. Risk factors for seizures and status epilepticus were compared between the fulminant cerebral edema group (n = 25, 19 seizures, including 12 status epilepticus) and control group (nonfulminant cerebral edema) (n = 1013, 444 seizures, including 141 status epilepticus; p = 0.001 for seizures and p < 0.001 for status epilepticus). Conclusion Our findings indicate that preceding seizures and status epilepticus are significant risk factors for fulminant cerebral edema in children with acute encephalitis.

Original languageEnglish
Pages (from-to)402-407
Number of pages6
JournalPediatrics and Neonatology
Volume57
Issue number5
DOIs
StatePublished - 01 10 2016

Bibliographical note

Publisher Copyright:
© 2016

Keywords

  • brain herniation
  • fulminant cerebral edema
  • pediatric encephalitis
  • status epilepticus

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