Consensus guidelines on evaluation and management of suspected acute viral encephalitis in children in India

Sharma, Suvasini; Mishra, Devendra; Aneja, Satinder; Kumar, Rashmi; Jain, Amita; Vashishtha, Vipin M

doi:10.1007/s13312-012-0216-0

Cited by 39 publications

(25 citation statements)

References 43 publications

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“…9 Longterm outcome is good. 2,9 In our study, 78% had complete recovery. That is the importance of checking NMDA antibody in CSF.…”

Section: Discussionsupporting

confidence: 50%

“…Objectives of the study were: (1) incidence of anti-NMDA antibody positivity among children, 3 months to 12 years, presenting as acute encephalopathy; (2) clinical profile, initial treatment response and one year neuropsychiatric status of the affected children. Children with pre-existent neurological illness, acute poisoning, post-immunisation and post-traumatic cases were excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

“…It may present as a paraneoplastic syndrome in ovarian and testicular tumours, neuroblastoma, and Hodgkin lymphoma. 2,3 …”

mentioning

confidence: 99%

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Incidence and Clinical Profile of Anti-N-Methyl-D-Aspartate Receptor Encephalitis in Children

Nair¹,

Parameswaran²

2016

jemds

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BACKGROUNDEncephalitis in children is associated with high rate of morbidity and mortality. Many sporadic cases of encephalitis in children have recently been found to be CSF negative for infective markers. Antibodies against neuronal proteins in CSF are being detected more frequently in such patients and are well responsive to immunotherapy, if timely diagnosed. Anti-N-Methyl-D-Aspartate receptor (anti-NMDA) antibody mediated encephalitis is the most common in children among this group.The objective of this study was to determine the incidence and clinical profile of anti-NMDA antibody mediated encephalitis in children and its early (6-8 weeks) and late (1 year) treatment responses. MATERIALS AND METHODSIt was a descriptive study done in a tertiary care teaching hospital in south India. All children, 3 months to 12 years, presenting as acute encephalopathy, from January 2012 to December 2014 were evaluated and those with CSF anti-NMDA antibody positive children were treated with standard protocol and followed up at 6 weeks, 8 weeks and one year. RESULTSWe had 178 children presented as acute encephalitis during the 3-year period. 18 (10%) children were positive for anti NMDA antibody in CSF. Female gender predominated by 89%. Predominant clinical features were in the descending order, behaviour and psychiatric 89%, speech dysfunction 72 %, movement disorders 56%, seizures 22% and autonomic phenomena 6%. Majority (78%) responded completely to immunotherapy. CONCLUSIONAnti-NMDA receptor encephalitis is not rare in children. In children presenting as acute encephalitis with predominant neuropsychiatric symptoms or if CSF negative for infection, NMDA antibody test in CSF is a must. Prompt diagnosis is important because it is amenable to immunotherapy and longterm prognosis is very good.

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“…9 Longterm outcome is good. 2,9 In our study, 78% had complete recovery. That is the importance of checking NMDA antibody in CSF.…”

Section: Discussionsupporting

confidence: 50%

Section: Methodsmentioning

confidence: 99%

See 1 more Smart Citation

Incidence and Clinical Profile of Anti-N-Methyl-D-Aspartate Receptor Encephalitis in Children

Nair¹,

Parameswaran²

2016

jemds

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“…The virological evaluation of pediatric patients with suspected virus encephalitis should be guided by several factors, including age, season, geography, and clinical manifestations. [57][58][59] Infections with certain viruses, such as the arboviruses, are restricted to specific seasons and geographical regions, whereas others, such as the herpesviruses, occur worldwide and year round. Serological techniques and the polymerase chain reaction (PCR), the principal methods to detect viral infections of the CNS, have reasonable sensitivity and specificity for most viral pathogens.…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Virus and Immune-Mediated Encephalitides: Epidemiology, Diagnosis, Treatment, and Prevention

Bale

2015

Pediatric Neurology

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Virus encephalitis remains a major cause of acute neurological dysfunction and permanent disability among children worldwide. Although some disorders, such as measles encephalomyelitis, subacute sclerosing panencephalitis, and varicella-zoster virus-associated neurological conditions, have largely disappeared in resource-rich regions because of widespread immunization programs, other disorders, such as herpes simplex virus encephalitis, West Nile virus-associated neuroinvasive disease, and nonpolio enterovirus-induced disorders of the nervous system, cannot be prevented. Moreover, emerging viral disorders pose new, potential threats to the child's nervous system. This review summarizes current information regarding the epidemiology of virus encephalitis, the diagnostic methods available to detect central nervous system infection and identify viral pathogens, and the available treatments. The review also describes immune-mediated disorders, including acute disseminated encephalomyelitis and N-methyl-D-aspartate receptor antibody encephalitis, conditions that mimic virus encephalitis and account for a substantial proportion of childhood encephalitis.

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“…Sharma et al highlighted the problems that were encountered during the management of suspected cases of viral encephalitis. These included paucity of data about the regional epidemiology and etiology of viral encephalitis, lack of easily available, low-cost microbiological testing for agents of viral encephalitis, lack of specific treatments for majority of the etiological agents, high incidence of mimickers-pyogenic meningitis, cerebral malaria, tubercular meningitis, acute disseminated encephalomyelitis, lack of facilities for intensive care in the periphery, lack of facilities for neuroimaging in the periphery, inappropriate response during epidemics-what samples to take, how to store, whom to inform, patient delay in seeking health care, delay/not performing lumbar punctures and inappropriate supportive care [4].…”

Section: Introductionmentioning

confidence: 99%

The Etiological Diagnosis and Outcome in Patients of Acute Viral Encephalitis: A Prospective Observational Study at Tertiary Care Centre of North India

Bhagchandani¹,

Atam²,

Thadani³

2016

J Neuroinfect Dis

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Consensus guidelines on evaluation and management of suspected acute viral encephalitis in children in India

Cited by 39 publications

References 43 publications

Incidence and Clinical Profile of Anti-N-Methyl-D-Aspartate Receptor Encephalitis in Children

Incidence and Clinical Profile of Anti-N-Methyl-D-Aspartate Receptor Encephalitis in Children

Virus and Immune-Mediated Encephalitides: Epidemiology, Diagnosis, Treatment, and Prevention

The Etiological Diagnosis and Outcome in Patients of Acute Viral Encephalitis: A Prospective Observational Study at Tertiary Care Centre of North India

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