Management and outcome of viral encephalitis in children

Abstract

Although viral encephalitis (VE) is relatively uncommon in children in the UK, early recognition and appropriate investigation and management are essential because of the devastating nature of the condition. An estimated 1200 paediatric cases from all causes are admitted each year. The cause of VE is diagnosed in approximately 30% of cases. The commonest cause in the UK is herpes simplex virus type 1 but globally the most important cause is Japanese encephalitis virus. Diagnostic methods have improved recently and the yield can be increased with a rational approach to investigations and by taking specialist advice. Morbidity and mortality are high but can be significantly reduced in herpes simplex virus encephalitis by treating for at least 14 days with intravenous aciclovir. Sequelae are common and include motor, sensory and cognitive impairments, epilepsy, behaviour problems and psychiatric disorders. Children should have access to a neurorehabilitation team, which includes a neuropsychologist, to achieve the best recovery possible. Long term follow-up and an organized transition into adult services is required.