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Pediatric encephalitis

Taha Moussa, Khalid Afzal, Joseph Cooper, Ryan Rosenberger, Karyn Gerstle, Linda Wagner-Weiner
BACKGROUND: Anti-NMDA receptor encephalitis, an autoimmune disease associated with antibodies against N-methyl-D-aspartate (NMDA) receptors, is being diagnosed more frequently, especially in children and young adults. Acute neurological and psychiatric manifestations are the common presenting symptoms. Diagnosing anti-NMDA receptor encephalitis is often challenging given the wide range of clinical presentation, and may be further complicated by its overlap of symptoms, brain MRI changes, and CSF findings with other entities affecting the brain...
February 18, 2019: Pediatric Rheumatology Online Journal
Noboru Oyachi, Takaki Emura, Fuminori Numano, Tomoko Tando, Tomohiro Saito, Yusuke Goto
BACKGROUND: Non-occlusive mesenteric ischemia (NOMI) is a rare and severe pathological condition that can cause intestinal necrosis without mechanical obstruction of the mesenteric artery. NOMI often develops during the treatment of severe disease in elderly patients and mostly occurs in the intestine supplied by the superior mesenteric artery (SMA). We experienced a 12-year-old patient with NOMI that was segmentally localized in the ascending colon and rectum during encephalitis treatment...
February 15, 2019: Surgical Case Reports
Geoffrey C Owens, Alejandro J Garcia, Aaron Y Mochizuki, Julia W Chang, Samuel D Reyes, Noriko Salamon, Robert M Prins, Gary W Mathern, Aria Fallah
Brain-infiltrating lymphocytes (BILs) were isolated from resected brain tissue from 10 pediatric epilepsy patients who had undergone surgery for Hemimegalencephaly (HME) ( n = 1), Tuberous sclerosis complex (TSC) ( n = 2), Focal cortical dysplasia (FCD) ( n = 4), and Rasmussen encephalitis (RE) ( n = 3). Peripheral blood mononuclear cells (PBMCs) were also isolated from blood collected at the time of the surgery. Cells were immunostained with a panel of 20 antibody markers, and analyzed by mass cytometry. To identify and quantify the immune cell types in the samples, an unbiased clustering method was applied to the entire data set...
2019: Frontiers in Immunology
Laura Rosas, Kavya Rao, Christine McGough, Ashley Becker
The authors describe a 12-year-old girl with an atypical presentation of Bartonella encephalitis. She presented with fever and altered mental status and developed flaccid paralysis of her left upper extremity a day later. An electroencephalogram showed slowing over her right hemisphere. She had mild leukocytosis and bandemia, but her imaging and cerebrospinal studies were unrevealing. After five days, her symptoms resolved and she was discharged home on doxycycline due to suspicion for Bartonella encephalitis...
2019: Child Neurology Open
Joseph J Cooper, Khalid I Afzal
No abstract text is available yet for this article.
February 1, 2019: Journal of ECT
Adriana Fumarola, Paolo Ricciardelli, Claudia Guiducci, Giuliana Turlà, Patrizia Cenni, Federico Marchetti
We report the case of a 6-year-old girl who presented with encephalitis during type B influenza. The clinical picture was characterized by an alteration of the state of consciousness associated with focal neurological signs with electroencephalographic changes and brain MRI. Clinical improvement was rapid and without neurological outcomes. The clinical characteristics, the pathogenic mechanisms, the prognosis and the therapy of neuroinfluenza cases are described.
January 2019: Recenti Progressi in Medicina
Ananth P Abraham, Maya Mary Thomas, Vivek Mathew, Karthik Muthusamy, Sangeetha Yoganathan, G Edmond Jonathan, Krishna Prabhu, Roy Thomas Daniel, Ari G Chacko
OBJECTIVE: To determine whether preoperative non-lateralizing scalp electroencephalography (EEG) influences seizure outcome following peri-insular hemispherotomy (PIH) in pediatric hemispheric epilepsy. METHODS: Retrospective data was collected on all 45 pediatric patients who underwent PIH between 2005 and 2016. All underwent a basic pre-surgical evaluation consisting of detailed history and examination, neuropsychological assessment, MRI, and EEG. SPECT/PET, fRMI, or Wada testing were done in only eight patients...
January 30, 2019: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
G L Wang, F Yin, Y Wang, W X Zhang, F He, L F Yang, L W Wu, J Peng
Objective: To investigate the clinical features, treatment strategies and long term outcomes of children with anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Methods: The data of clinical features, auxiliary examinations, treatments and prognosis in children with anti-NMDAR encephalitis in Xiangya Hospital of Central South University from March 2014 to October 2017 were collected and retrospectively analyzed. A total of 71 patients were enrolled, including 33 males and 38 females. The youngest age of onset was 4 months old, and the age of onset was (9±4) years...
February 2, 2019: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
Yuji Kamata, Yuki Shinohara, Keita Kuya, Yoshiko Tsubouchi, Yoshiaki Saito, Yoshihiro Maegaki, Shinya Fujii, Toshihide Ogawa
BACKGROUND: Computed diffusion-weighted imaging (DWI) (cDWI) is a computational technique that can be used to calculate a high b-value image from DWI acquired with at least two different lower b-values. PURPOSE: To explore the utility of cDWI for the diagnosis of acute pediatric encephalitis/encephalopathy. MATERIAL AND METHODS: Twenty-two children were enrolled, for whom acquired DWI (aDWI) with b = 1000 and 3000 was examined during the acute phase of febrile encephalitis/encephalopathy...
January 23, 2019: Acta Radiologica
Mildred A Iro, Manish Sadarangani, Alecia Nickless, Dominic F Kelly, Andrew J Pollard
BACKGROUND: Encephalitis is a serious neurologic condition which can result in admission to intensive care. Yet, there are no studies on pediatric intensive care unit (PICU) admission rates and usage of intensive care resources by children with encephalitis in England and Wales. The objectives of this study were to (i) define the PICU incidence and mortality rates for childhood encephalitis, (ii) describe usage of intensive care resources by children with encephalitis admitted to PICU, and (iii) explore the associated cost from PICU encephalitis admissions...
January 3, 2019: Pediatric Infectious Disease Journal
Napa Pruetarat, Wiracha Netbaramee, Siriporn Pattharathitikul, Montida Veeravigrom
OBJECTIVE: Anti-NMDAR encephalitis is an acute autoimmune neurological disorder that is increasingly recognized in pediatric populations. Several studies of the disorder have been conducted worldwide but there are few publications in Thailand. Here, we describe the clinical manifestations, treatment outcomes, and prognostic factors in children with anti-NMDAR encephalitis. METHODS: Between January 2007 and September 2017, we conducted a retrospective/prospective cohort study of children diagnosed with anti-NMDAR encephalitis from three tertiary care hospitals in Thailand: King Chulalongkorn Memorial Hospital, Chonburi Hospital, and Prapokklao Hospital...
January 10, 2019: Brain & Development
Yang-Kai Fan, Yu-Peng Liu
Coxsackievirus, a common pathogen causing pediatric infection, typically causes a mild, nonspecific illness with low-grade fever, but can cause severe illness on rare occasions. Encephalitis is an uncommon but important complication of coxsackievirus infection. The magnetic resonance imaging (MRI) findings of coxsackievirus B3 (CVB3) encephalitis have not been reported in the literature, and there are few descriptions of MRI findings of encephalitis induced by coxsackieviruses of other serotypes. We report the MRI findings of CVB3 encephalitis in a two-year-old girl, review the MRI findings in previously reported cases of pediatric coxsackievirus encephalitis, and present the MRI characteristics of coxsackievirus encephalitis...
January 9, 2019: Journal of the Belgian Society of Radiology
Rachelle Herring, Nilesh Desai, Mered Parnes, Imad Jarjour
Over the past two decades, West Nile virus has become the most common arbovirus in North America, leading to several outbreaks and infecting thousands of people. Mosquitos help transmit the virus in the majority of cases, but transmission occurs via blood transfusions, organ transplantation, and possibly pregnancy and breastfeeding. While most infected patients experience mild to no symptoms, thousands of West Nile virus-associated neuroinvasive cases have been reported in the United States, with over 700 cases occurring in children from 2003 to 2016...
November 28, 2018: Pediatric Neurology
Jonathan D Santoro
Bickerstaff brainstem encephalitis is a rare, immune-mediated disorder of the brainstem and peripheral nervous system. Published knowledge of pediatric Bickerstaff brainstem encephalitis focuses on the acute phase of the disease process. This study evaluated long-term neurologic and immune sequelae of Bickerstaff brainstem encephalitis in children. A single-center retrospective chart review was performed. Clinical data, neuroimaging, polysomnograms, and serum data were reviewed. Five patients were included in this study...
January 3, 2019: Journal of Child Neurology
Susanna Esposito, Nicola Principi, Paolo Calabresi, Donato Rigante
Autoimmune encephalitis encompasses a wide variety of protean pathologic processes associated with the presence of antibodies against neuronal intracellular proteins, synaptic receptors, ion channels and/or neuronal surface proteins. This type of encephalitis can also involve children with complex patterns of seizures and unexpected behavioural changes, which jeopardize their prompt recognition and treatment. Many epidemiological studies have shown that numerous immune-based forms of encephalitis can be encountered, almost surpassing the rate of postinfectious encephalitides...
February 2019: Autoimmunity Reviews
Carmen Niño Taravilla, Isabel Pérez-Sebastián, Alberto García Salido, Claudia Varela Serrano, Verónica Cantarín Extremera, Anna Duat Rodríguez, Laura López Marín, Mercedes Alonso Sanz, Olga María Suárez Traba, Ana Serrano González
We conducted an observational study from January 2016 through January 2017 of patients admitted to a reference pediatric hospital in Madrid, Spain, for neurologic symptoms and enterovirus infection. Among the 30 patients, the most common signs and symptoms were fever, lethargy, myoclonic jerks, and ataxia. Real-time PCR detected enterovirus in the cerebrospinal fluid of 8 patients, nasopharyngeal aspirate in 17, and anal swab samples of 5. The enterovirus was genotyped for 25 of 30 patients; enterovirus A71 was the most common serotype (21/25) and the only serotype detected in patients with brainstem encephalitis or encephalomyelitis...
January 2019: Emerging Infectious Diseases
Palita Arayakarnkul, Krisnachai Chomtho
BACKGROUND: Super-refractory status epilepticus (SRSE) is a seizure that continues >24 h after anesthesia, or recurs on the reduction of anesthesia. SRSE is extremely difficult-to-control and associated with poor outcome. To date, optimal therapy and outcome data in children is limited. OBJECTIVE: To assess etiology, treatment options and outcome in pediatric SRSE patients. METHOD: We reviewed medical records of children <15 years old with SRSE during 2007-2017 at King Chulalongkorn Memorial Hospital...
December 7, 2018: Brain & Development
Murat Sütçü, Hacer Aktürk, Sezen Gülümser-Şişko, Manolya Acar, Oğuz Bülent Erol, Ayper Somer, Bilge Bilgiç, Nuran Salman
Sütçü M, Aktürk H, Gülümser-Şişko S, Acar M, Erol OB, Somer A, Bilgiç B, Salman N. Granulomatous amebic encephalitis caused by Acanthamoeba in an immuncompetent child. Turk J Pediatr 2018; 60: 340-343. Acanthamoeba may lead to granulomatous amebic encephalitis (GAE) with high mortality rates generally in patients with immunosupression and/or chronic disease. Here, we present a rare GAE case, who was a previously healthy child. A Georgian 9 year old boy presented with focal seizure on his left arm and confusion...
2018: Turkish Journal of Pediatrics
A Michev, P Musso, T Foiadelli, C Trabatti, A Lozza, D Franciotta, A M Simoncelli, S Savasta
Bickerstaff Brainstem Encephalitis (BBE) is a rare autoimmune encephalitis, characterized by acute ophthalmoplegia, ataxia and altered state of consciousness. Together with Guillan-Barrè Syndrome (GBS) and Miller-Fisher Syndrome, it forms a spectrum of post-infectious demyelinating diseases. Overlapping forms between BBE and GBS (BBE/GBS) are described in patients with lower limbs weakness and typical signs of BBE, suggesting a combined involvement of Central and Peripheral Nervous System (PNS), but only few reported cases are focused on pediatric population...
January 2019: European Journal of Paediatric Neurology: EJPN
Salvatore Savasta, Francesca Rovida, Thomas Foiadelli, Anna Maria Campana, Elena Percivalle, Gian Luigi Marseglia, Fausto Baldanti
BACKGROUND: West Nile virus (WNV) is a mosquito-borne RNA virus belonging to the Flaviviridae family. Symptomatic infection happens in only about 20% of the cases, while WNV neuroinvasive disease (WNND) is rare and accounts for less than 1%. There is insufficient information about natural history and clinical course in children, because underdiagnosis is common, and reports are scarce. On the other hand, Europe has seen a dramatic increase of WNV infections in the last decades, and the Po valley itself, in Northern Italy, has become an endemic region since 2013...
November 20, 2018: Italian Journal of Pediatrics
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