Polymerase chain reaction-proved herpes simplex encephalitis in children
Polymerase chain reaction-proved herpes simplex encephalitis in children
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DOI：
10.1097/00006454-199801000-00007
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发表时间：
1998-01-01
影响因子：
3.6
通讯作者：
Morishima, T
中科院分区：
文献类型：
--
作者：
Ito, Y;Ando, Y;Morishima, T
目的：探讨不包括新生儿的单纯疱疹病毒性脑炎（HSE）的临床特点。方法：对24例经PCR证实为单纯疱疹病毒性脑炎的患儿的临床表现和实验室检查结果进行分析，并与38例非单纯疱疹病毒性脑炎的中枢神经系统感染患儿的临床表现和实验室检查结果进行比较。脑脊液分析显示细胞计数、蛋白质和葡萄糖浓度无显著差异，24例HSE患者中18例（75%）和32例非HSE患者中10例（31%）发现局部异常（P = 0.001），周期性偏侧癫痫样放电，脑电图异常发现，在22例HSE患者中，有8例（36%）检测到，非HSE患者中无一例（P = 0.0001）， HSE患者中至重度发病率和死亡率显著高于非HSE患者，在格拉斯哥昏迷量表评分大于等于11分的9例HSE患者中，所有患者均完全康复。年龄小于3岁的HSE患者比年龄较大的患者更容易发生严重的后遗症或死亡（P = 0.02）。结论：HSE患者无特定的临床特征，脑电图和计算机断层扫描结果对HSE的诊断有帮助，但不能证实。格拉斯哥昏迷评分和年龄对HSE患者的死亡率和发病率有显著影响。
Objective, To investigate the clinical features in PCR-proved herpes simplex encephalitis (HSE) in children, excluding neonates,Methods, We studied the clinical manifestations and laboratory findings of 24 children in whom the diagnosis of herpes infection was confirmed by the PCR assay and compared them with those of 38 children with central nervous system infections other than HSE,Results, There were no significant differences between groups in the percentage with fever or convulsions, the initial neurologic symptoms or the level of consciousness, Analysis of cerebrospinal fluid showed no significant differences in the cell count or concentration of protein and glucose, Computerized tomography of the brain identified localized abnormalities in 18 (75%) of the 24 HSE patients and in 10 (31%) of the 32 non-HSE patients (P = 0.001), Periodic lateralized epileptiform discharges, abnormal findings on electroencephalography, were detected in 8 (36%) of 22 HSE patients and in none of the non-HSE patients (P = 0.0001), The rates of moderate to severe morbidity and death were significantly higher in the HSE patients than in the non-HSE patients, Of the 9 HSE patients with a Glasgow Coma Scale score greater than or equal to 11, all patients recovered completely. HSE patients younger than 3 years of age were more likely to develop severe sequelae or to die of the disorder than older patients (P = 0.02),Conclusions, There were no specific clinical characteristics of HSE patients, The results of electroencephalography and computerized tomography were helpful, but not confirmatory, in diagnosing HSE. The Glasgow Coma Scale score and age significantly influenced the mortality and morbidity in the HSE patients.