AUTHORS:  SABHARWAL RK, KUMAR PRAVEEN, BHOJWANI SUMIT, JAIN SAPNA

DIVISION OF CHILD NEUROLOGY; INSTITUTE OF CHILD HEALTH, SIR GANGA RAM HOSPITAL, NEW DELHI.

ABSTRACT

The WHO defines the Acute Encephalitis Syndrome(AES) as the acute onset of fever with change in mental status ( including symptoms such as confusion, disorientation, inability to talk, or coma) and often associated with the new onset of seizures ( excluding febrile seizures).  AES is a common reason for pediatric ICU admission; the course of the illness may resolve in a benign manner or evolve into a life – threatening emergency.

The causative agent of AES varies with season and geographical location, and predominantly affects population below 15 years.  We present an analysis of 126 cases of AES admitted to PICU over a 30 month period. Majority of the patients were below 5 years of age (42%) and males predominated in the series (71%). Patients underwent hematological tests, blood biochemistries, cerebrospinal fluid (CSF) analysis including viral and autoimmune tests where indicated. EEG’s, brain MR imaging were done in almost all patients, and PET scan in few. The results revealed that immune – mediated disorders including acute demyelinating encephalomyelitis (ADEM) and auto immune encephalitis constituted the largest group. Mortality in the series was 8.2%. Over 16% of the patients remained undiagnosed.