Analysis Of Risk Factors For Japanese Encephalitis-Related Posterncephalitic Epilepsy In Children

Objectives:To investigate the risk factors for Japanese encephalitis-related postencephalitic epilepsy in children by analyzing the clinical features of children with Japenese encephalitis (JE).Methods:Cases of Japanese encephalitis in Children’s Hospital of Chongqing Medical University from July 2009 to September 2014 were retrospectively reviewed. Cases were divided into two groups according to the results of follow-up (PEE group and non-PEE group). The clinical data included onset age, gender, hospital duration, clinical classification, frequency of witnessed seizures, state of consciousness, upper gastrointestinal bleeding, respiratory failure, EEG, neuroimaging findings. The association between each of these varibles and posterncephalitic epilepsy were analysed by multivariate stepwise logistic mode after univariate analysis.Results:Total 319 children were enrolled and 33 (10.3%) of them developed postencephalitic epilepsy in a follow-up period of 6 to 67 months(mean,30±16.5 months). The time interval between acute encephalitis and the development of PEE ranged from 2 weeks to 42 mouths (mean,7.46±11.27 months). Of these,24(72.7%) developed epilepsy within six months and 31(93.9%) within two years. With regard to seizures, partial seizures were common, and 61.3% of children with epilepsy still had seizures despite monotherapy.93.9% of the children with postencephalitic epilepsy had other sequelaes. Univariate analysis analysis showed that that onset age, hospital duration, clinical classification, seizures in acute phase, frequency of witnessed seizures, state of consciousness, upper gastrointestinal bleeding, respiratory failure, EEG, neuroimage findings were significantly different between two groups(P<0.05). Multivariate logistic stepwise analysis revealed that the significant risk factors for PEE included over five episodes of witnessed seizures (OR=14.459, P<0.001), status epilepticus (OR=24.766, P =0.008), coma (OR= 11.489, P=0.001), epileptiform discharges in EEG (OR=6.806, P=0.001), cortical lesions (OR=4.69, P=0.001).Conclusions:Over five episodes of witnessed seizures, status epilepticus, coma, epileptiform discharges in EEG and cortical lesions in neuroimage are risk factors for Japanese encephalitis-related postencephalitic epilepsy in children. Children with JE who have these prognostic factors above, more aggressive steps should be taken in clinical practice in order to get good prognosis.