Post-encephalitic syndrome in children with tick-borne encephalitis

Abstract

Tick-borne encephalitis is predominantly a disease with a milder clinical course in children, but in a small number of patients it may cause some severe and permanent sequels. The aim of this study was to investigate the prevalence and clinical characteristics of post-encephalitic syndrome in children with tick-borne encephalitis. The study was based on data obtained from longitudinal clinical monitoring of 112 children with tick-borne encephalitis aged 2-14 years, treated during the 1979-2011 period. In clinical monitoring, qualitative assessment of the post-encephalitic syndrome effect on everyday life habits and activities of patients was used. Clinical signs and symptoms of post-encephalitic syndrome were recorded in 35 (31.2%) patients, significantly more common among schoolchildren (38%) than preschool children (13%) (p<0.05). Post-encephalitic syndrome most frequently manifested as headache (74%), ataxia (34%), as well as movement disorder (including tremor) and dizziness (28%). Memory, attention and concentration disorders were present in 26% of patients, emotional disturbances (irritability) in 23%, and behavioral changes (aggression and “strange behavior”) in 11% of patients. Mild or transient post-encephalitic syndrome was recorded in 60%, moderately severe in 31%, and severe with permanent sequels in 9% of patients (3% of all patients with tick-borne encephalitis, with hearing loss in two and hemiparesis and epileptic seizure in one patient each). Post-encephalitic syndrome lasted for one to three months for up to more than ten years. In conclusion, this study undoubtedly proved the presence of post-encephalitic syndrome in study children with tick-borne encephalitis.