Abstract
Background: Central nervous system (CNS) infection in childhood can lead to neurological sequelae, including epilepsy, and neurodevelopmental disorders, such as attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). This study investigated the association of etiologically diagnosed childhood brain infections with the subsequent risks of epilepsy and neurodevelopmental disorders.Objectives: We retrospectively analyzed the data of children aged <18 years who had definite brain infections with positive cerebrospinal fluid cultures from January 1, 2005, to December 31, 2017. These patients were followed to evaluate the risks of epilepsy and neurodevelopmental disease (ADHD and ASD) after brain infections (group 1) in comparison with the risks in those without brain infections (group 2).Results: A total of 145 patients with an average age of 41.2 months were included in group 1. Enterovirus accounted for the majority of infections, followed by group B Streptococcus, S. pneumoniae, and herpes simplex virus. A total of 292 patients with an average age of 44.8 months were included in group 2. The 12-year risk of epilepsy in group 1 was 10.7 (95% confidence interval [CI], 2.30–49; p < 0.01). Compared with group 2 (reference), the risk of ASD in the age interval of 2–5 years in group 1 was 21.3 (95% CI, 1.33–341.4; p = 0.03). The incidence of ADHD in group 1 was not significantly higher than that in group 2.Conclusions: This study identified the common etiological causes of brain infections in Taiwanese children. The highest-risk neurodevelopmental sequelae associated with brain infections was epilepsy. Children who had a diagnosis of brain infection (specially Enterovirus) should be followed since they are at greater risk of developing epilepsy and ASD.
Highlights
Central nervous system (CNS) infections in childhood can be devastating and may lead to neurological sequelae or death
This study explored the neurodevelopmental outcomes of childhood brain infections with different microbiological etiologies, with the aim of developing strategies of prevention, early diagnosis, and targeted treatments for epilepsy and Neurodevelopmental disorders (NDDs) after CNS infections in children
We looked into the issues during their admission which may be related to long-term neurological sequelae: With or without ventilator use; 1st day Pediatric Glasgow Coma Scale, seizures pattern; type of Brain infections, with a view to see the association between various brain infections and clinical risk factors at admission with subsequent NDDs
Summary
Central nervous system (CNS) infections in childhood can be devastating and may lead to neurological sequelae or death. A greater understanding of causative agents may lead to greater opportunities to predict associated neurological outcomes of children later in life [1]. Seizures occur frequently in children with acute bacterial meningitis, only those with permanent neurologic deficits after meningitis are at a high risk of epilepsy [3, 4]. Seizures occur in children with acute viral encephalitis and increase the risk of later unprovoked seizures and epilepsy [5]. Central nervous system (CNS) infection in childhood can lead to neurological sequelae, including epilepsy, and neurodevelopmental disorders, such as attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD). This study investigated the association of etiologically diagnosed childhood brain infections with the subsequent risks of epilepsy and neurodevelopmental disorders
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