Rehabilitation outcomes in Acute Necrotizing Encephalopathy of Childhood – A Retrospective Study

Abstract

Aims & Objectives: To assess the outcome of early physiotherapy and rehabilitation in children with AcuteNecrotizing Encephalopathy of Childhood (ANEC).Methods: Retrospective review of 10 infants & children with ANEC at Department of Paediatrics,S.N.Medical College & HSK Hospital, Bagalkot from January 2013 to December 2019. ANEC wassuspected based on clinical and radiological characteristics and diagnosis was made based on diagnosticcriteria proposed by Mizuguchi et al. Clinical and radiological (MRI brain characteristics) findings andresponse to standard therapy, early physiotherapy and rehabilitation were assessed in all cases. All caseswere followed for evaluation of neurodevelopmental outcome.Results: The age ranged from 6 months to 11 years (7 female, 3 male). All cases had precedent viralillnesses and had fever, coryza, diarrhoea. The initial neurological symptoms included altered sensorium(n=3), seizures and status epilepticus (n=7), focal neurological signs, gait disturbances (n=2) and diplopia(n=1). MRI brain revealed characteristic thalamus involvement with varied involvement of midbrain, pons,medulla (n=10). 9 out of 10 cases survived, responded to standard medical therapy , early physiotherapy andrehabilitation. 6 children had complete recovery with minimal disability in 3 cases.Conclusions: Early detection and appropriate treatment improves outcome in ANEC. Physiotherapy helpsin remarkable improvement in the regain of tone, reflexes and movements of limbs