Acute Pediatric Encephalitis Neuroimaging: Single-Institution Series as Part of the California Encephalitis Project

Abstract Purpose Diagnosing pediatric encephalitis is challenging because of varied clinical presentation, nonspecific neuroimaging features, and rare confirmation of causality. We reviewed acute neuroimaging of children with clinically suspected encephalitis to identify findings that may correlate...

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Bibliographic Details
Published in:Pediatric neurology 2015-06, Vol.52 (6), p.606-614
Main Authors: Bykowski, Julie, MD, Kruk, Peter, MD, Gold, Jeffrey J., MD, PhD, Glaser, Carol A., DVM, MD, Sheriff, Heather, BA, Crawford, John R., MD, MS
Format: Article
Language:English
Subjects:
Adolescent
Brain - pathology
California
Child
Child, Preschool
computed tomography
encephalitis
Encephalitis - pathology
Female
Humans
Infant
M. pneumoniae
magnetic resonance imaging
Magnetic Resonance Imaging - methods
Male
Neurology
Pediatrics
Young Adult
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Summary:Abstract Purpose Diagnosing pediatric encephalitis is challenging because of varied clinical presentation, nonspecific neuroimaging features, and rare confirmation of causality. We reviewed acute neuroimaging of children with clinically suspected encephalitis to identify findings that may correlate with etiology and length of stay. Methods Imaging of 141 children with clinically suspected encephalitis as part of The California Encephalitis Project from 2005 to 2012 at a single institution was reviewed to compare the extent of neuroimaging abnormalities to patient age, gender, length of stay, and unknown, possible, or confirmed pathogen. Scan review was blinded and categorized by extent and distribution of abnormal findings. Results Abnormal findings were evident on 23% (22/94) of computed tomography and 50% (67/134) of magnetic resonance imaging studies in the acute setting. Twenty children with normal admission computed tomography had abnormal findings on magnetic resonance imaging performed within 2 days. Length of stay was significantly longer among children with abnormal acute magnetic resonance imaging ( P  
ISSN:0887-8994
1873-5150
DOI:10.1016/j.pediatrneurol.2015.02.024