Evidence map›Paper›PMID 37400659›Full record

ArticleJournal of neurology2023

Acute pediatric encephalitis: etiology, course, and outcome of a 12-year single-center immunocompetent cohort.

Giacomo Brisca, Chiara Marini, Silvia Buratti, Marcello Mariani, Domenico Tortora, Giovanni Morana, Daniela Pirlo, Marta Romanengo, Giulia Cannizzaro, Ramona Cordani and 7 more

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Article in Journal of neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Giacomo BriscaIntermediate Care Unit, Emergency Department, IRCCS Istituto Giannina Gaslini, Genoa, Italy. giacomobrisca@gmail.com.ORCID http://orcid.org/0000-0001-7992-0181
Chiara MariniPediatrics 1, Maria Vittoria Hospital, ASL Città Di Torino, Turin, Italy.
Silvia BurattiNeonatal and Pediatric Intensive Care Unit, Emergency Department, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Marcello MarianiPediatric Infectious Diseases Unit, Department of Pediatrics, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Domenico TortoraNeuroradiology Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Giovanni MoranaDepartment of Neurosciences, University of Turin, Turin, Italy.
Daniela PirloIntermediate Care Unit, Emergency Department, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Marta RomanengoIntermediate Care Unit, Emergency Department, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Giulia CannizzaroAzienda Ospedaliera Universitaria IRCCS Meyer, Florence, Italy.
Ramona CordaniDepartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Francesca CanzoneriDepartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Maria Grazia CalevoEpidemiology and Biostatistics Unit, Scientific Direction, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Lino NobiliDepartment of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Diego FranciottaIRCCS Mondino Foundation, Pavia, Italy.
Elio CastagnolaPediatric Infectious Diseases Unit, Department of Pediatrics, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Andrea MoscatelliIntermediate Care Unit, Emergency Department, IRCCS Istituto Giannina Gaslini, Genoa, Italy.
Maria Margherita MancardiChild Neuropsychiatry Unit, Department of Neurosciences, IRCCS Istituto Giannina Gaslini, Genoa, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundEncephalitis is an uncommon but severe disorder due to an inflammation of the brain parenchyma, usually diagnosed on clinical, laboratory, electroencephalographic, and neuroradiological features. New causes of encephalitis have been reported in recent years, so diagnostic criteria have changed over time. We report on a single-center experience of a pediatric Hospital, the hub of its region, over 12 years (2008-2021), with the evaluation of all children managed for acute encephalitis.

methodsWe retrospectively reviewed clinical, laboratory, neuroradiological, and EEG data from the acute phase and outcome of all immunocompetent patients diagnosed with acute encephalitis. According to the newly proposed criteria for pediatric autoimmune encephalitis, we divided patients into infectious, definite autoimmune, probable autoimmune, and possible autoimmune, and performed a comparison between the different groups.

results48 patients (26 females, mean age 4.4 years), 19 with infections, and 29 with autoimmune encephalitis, were included. Herpes simplex virus 1 encephalitis was the most frequently identified etiology followed by anti-NMDA receptor encephalitis. Movement disorders at onset and a longer hospital stay were observed more frequently in autoimmune compared to infectious encephalitis (p p < 0.001 and p = 0.001, respectively). Among the autoimmune group, children who started immunomodulatory treatment earlier (within 7 days from onset) had more frequent complete functional recovery (p = 0.002).

conclusionsHerpes virus and anti-NMDAR encephalitis are the most frequent etiologies within our cohort. Clinical onset and course are extremely variable. Since early immunomodulatory treatment was associated with a better functional outcome, our data confirm that a timely diagnostic classification in definite, probable, or possible autoimmune encephalitis can help the clinician in a successful therapeutic approach.

Indexed as

Anti-N-Methyl-D-Aspartate Receptor EncephalitisHashimoto DiseaseBrainChildChild, PreschoolEncephalitisFemaleHumansRetrospective StudiesAntineuronal antibodiesAutoimmune encephalitisBrain inflammationEarly antiviral and immunomodulatory treatmentInfectious encephalitis

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.