Abstract
Aim
To identify prognostic factors for severe neurological sequelae and epileptic seizures
in children with human herpes virus (HHV) 6/7-associated acute encephalopathy (AE).
Methods
We retrospectively studied pediatric cases of HHV6/7-associated AE between April 2011
and March 2021. Neurological sequelae were assessed using the Pediatric Cerebral Performance
Category scale (PCPC) and the presence of epileptic seizures 1 year after onset. We
investigated the prognostic factors between the non-severe sequelae group (PCPC scores ≤ 2)
and severe sequelae group (PCPC scores ≥ 3) in patients without severe neurological
complications before onset.
Results
Forty patients, ranging from 4 to 95 months old, were included. AE with biphasic seizures
and late reduced diffusion were the most common types of encephalopathy (n = 28).
Among the 36 patients evaluated neurological sequelae, 17, nine, eight, and two were
categorized as PCPC 1, 2, 3 and 4, respectively. Epileptic seizures were observed
in nine patients. In the severe sequelae group, significantly more cases with coma
in the acute phase and thalamic lesions on MRI and higher serum aspartate aminotransferase,
alanine aminotransferase (ALT), and lactate dehydrogenase levels were observed. Multivariate
analysis showed a significant between-group difference in the rate of coma (p = 0.0405). Patients with epileptic seizures had a higher rate of coma and thalamic
lesions and higher serum ALT and urinary beta 2-microglobulin levels, but there was
no significant difference in the multivariate analysis.
Conclusions
In HHV6/7-associated AE, coma was a significant prognostic factor for severe neurological
sequelae.
Keywords
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Article info
Publication history
Published online: October 26, 2022
Accepted:
October 10,
2022
Received in revised form:
September 15,
2022
Received:
July 30,
2022
Identification
Copyright
© 2022 The Japanese Society of Child Neurology Published by Elsevier B.V. All rights reserved.
