MEASLES ENCEPHALITIS

Abstract

The histories of 42 patients with measles encephalitis were reviewed to evaluate the treatment, in particular to determine whether adrenal corticosteroids or adrenocorticotropin were helpful, beyond the results with usual supportive therapy. There were no fatalities, but 13 patients had central nervous system sequelae on discharge; 9 of these had been treated with, and 4 without ACTH and/or corticosteroids. Re-examination of 20 of the 42 cases 2 to 7 years after discharge from the hospital revealed that of 14 children treated during the acute phase of encephalitis with ACTH and/or corticosteroids, 12 had central nervous system sequelae, while only 6 of these 12 had manifested complications on discharge. Four of 6 untreated patients among the 20 followed-up had central nervous system sequelae, as compared to 4 of 22 at the time of discharge from the hospital. The patient's condition on discharge from the hospital did not accurately indicate the future course; some sequelae became manifest later, others disappeared, some became milder and others worse. Adrenal corticosteroids and ACTH administered to these patients did not prevent central nervous system complications. The advisability of the use of these hormones in the management of measles encephalitis is questioned. The survival of 42 consecutive patients indicates that some fatalities may be prevented by constant supervision and intensive supportive therapy.