Encephalitis in children: A clinical neuropsychology perspective

Starza-Smith, Arleta; Talbot, Emily; Grant, Colin A.

doi:10.1080/09602010701202154

Cited by 5 publications

(4 citation statements)

References 23 publications

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“…It is likely that poor cognitive, language, and motor outcomes will be linked to these variables. Vulnerable infants and young children likely are at the highest risk for morbidity and mortality (Starza-Smith et al, 2007).…”

Section: Anticipating a Neuropsychological Caseload Surgementioning

confidence: 99%

Neurotropic mechanisms in COVID-19 and their potential influence on neuropsychological outcomes in children

Condie

2020

Child Neuropsychology

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Children have shown more physical resilience to COVID-19 than adults, but there is a cohort of vulnerable infants and young children who may experience disease burden, both in the acute phase and chronically. Children may have had early undocumented exposure to COVID-19. Even when the risk of exposure was known, developmental variables may have made the avoidance of physical proximity difficult for children. Preliminary hypotheses concerning neurotropic factors have been documented by researchers. Children with COVID-19 and comorbid physical or mental disorders may be vulnerable to exacerbations of neurotropic factors and comorbidities, the neural impact of which has been documented for other coronaviruses. Researchers are investigating COVID-19 symptom descriptions, neurotropic mechanisms at the genomic and transcriptomatic levels, neurological manifestations, and the impact of comorbid health complications. Neuropsychologists need information concerning the likely impact of COVID-19 on children. With a view toward that goal, this article provides recommendations for some initial updates in neuropsychology practice. ARTICLE HISTORY

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Section: Anticipating a Neuropsychological Caseload Surgementioning

confidence: 99%

Neurotropic mechanisms in COVID-19 and their potential influence on neuropsychological outcomes in children

Condie

2020

Child Neuropsychology

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“…Physical symptoms may be evident on medical exam (e.g., fever, seizures), but dramatic behavioral changes may be important signs of an encephalitic condition (Ebaugh, 2007). In one study, an alarming 90% of infected children demonstrated "considerable" deficits in cognitive functioning, with 65% exhibiting moderate impairment in more specific executive functioning domains (Starza-Smith et al, 2007). Earlier age of infection has been associated with more severe and pervasive central nervous system (CnS) impairments (v. Anderson, Anderson, grimwood, & nolan, 2004).…”

Section: Infectious Diseasesmentioning

confidence: 99%

“…Epidemiological studies have suggested the incidence of encephalitis is about 16 cases per 100,000 children, with rates for some causes higher in developing countries (Starza-Smith, talbot, & grant, 2007). Encephalitis is typically caused by infection and subsequent brain tissue inflammation, so there are many causes.…”

Section: Infectious Diseasesmentioning

confidence: 99%

Chronic pediatric medical conditions and comorbid psychopathology.

Steck-Silvestri¹,

Phelps²,

MacAllister³

et al. 2013

Neuropsychological Assessment and Intervention for Youth: An Evidence-Based Approach to Emotional and Behavioral Disorders.

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Approximately 5 million (or 7%) of children in the united States have a chronic medical condition that affects their daily functioning (national Center for Health Statistics, 2006). the prevalence of chronic medical conditions in children has more than tripled in recent decades (Perrin, Bloom, & gortmaker, 2007), which may be attributed to a decrease in infant mortality, improved medical care for pediatric life-threatening conditions, and amplified incidence of communicable diseases, many of which affect central nervous system function. In addition to genetic causes or susceptibility, environmental factors such as neurotoxin exposure, infectious disease, and acquired injuries may lead to compromised brain function and overall child adjustment.Although medical stabilization may be of primary concern when treating pediatric health conditions, secondary effects on brain function, particularly frontal-subcortical circuit function, are of critical importance givenCopyright American Psychological Association. Not for further distribution. 300 steck-silvestri et al.circuit influence on adaptive behavior, psychosocial adjustment, and psychopathology. these neuropsychological effects of medical conditions not only influence overall adjustment but also affect the length, duration, intensity, and course of medical care in a reciprocal manner.this chapter presents the neuropsychological, behavioral, and emotional sequelae in pediatric illnesses with psychopathology (see table 13.1), but it is important to recognize that this discussion is illustrative, not exhaustive. the chapter concludes with an epilepsy case example highlighting the importance of clinical and neuropsychological assessment methods that lead to effective interventions.nEuRODEvELOPMEntAL InSuLtS Prematurity and Low Birth WeightAdvances in neonatal care have resulted in increased survival rates of extremely low birth weight (ELBW; <1,000 g or 2.2 lb) or very preterm (<28 weeks gestation) infants. Born with immature nervous systems vulnerable to insult, these children experience increased risk of attention, internalizing, and adaptive behavior problems (e.g., P. Anderson & Doyle, 2003). Meta-analyses show that the cognitive functioning of preterm children is directly proportional to birth weight and gestational age (Bhutta, Cleves, Casey, Cradock, & Anand, 2002). Children with ELBW are more likely than children of normal birth weight to have cerebral palsy, asthma, low IQ and adaptive functioning, and executive, memory, and motor impairments (taylor, Drotar, Schluchter, & Hack, 2006).neuroimaging findings have suggested that ELBW infants are more likely to have white matter brain injury and reduced brain volume (e.g., Skranes et al., 2007), including hippocampal volume (Isaacs et al., 2000), which could account for their frequent attention, executive, working memory, visual-perceptual, social, and learning problems. Psychosocial concerns have been reported in about 40% of children with low birth weight (LBW), with about 27% experiencing psychiatric diagnoses (...

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“…Moreover, current knowledge about encephalitis is limited to descriptive statistics. As a result, a comprehensive understanding of human encephalitis, as generated through high quality evidence-based studies and statistical analyses is limited and much of the current knowledge base lacks generalizability [ 2 , 9 - 11 ].…”

Section: Introductionmentioning

confidence: 99%

Potential risk factors associated with human encephalitis: application of canonical correlation analysis

Hamid

Meaney

Crowcroft

et al. 2011

BMC Med Res Methodol

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BackgroundInfection of the CNS is considered to be the major cause of encephalitis and more than 100 different pathogens have been recognized as causative agents. Despite being identified worldwide as an important public health concern, studies on encephalitis are very few and often focus on particular types (with respect to causative agents) of encephalitis (e.g. West Nile, Japanese, etc.). Moreover, a number of other infectious and non-infectious conditions present with similar symptoms, and distinguishing encephalitis from other disguising conditions continues to a challenging task.MethodsWe used canonical correlation analysis (CCA) to assess associations between set of exposure variable and set of symptom and diagnostic variables in human encephalitis. Data consists of 208 confirmed cases of encephalitis from a prospective multicenter study conducted in the United Kingdom. We used a covariance matrix based on Gini's measure of similarity and used permutation based approaches to test significance of canonical variates.ResultsResults show that weak pair-wise correlation exists between the risk factor (exposure and demographic) and symptom/laboratory variables. However, the first canonical variate from CCA revealed strong multivariate correlation (ρ = 0.71, se = 0.03, p = 0.013) between the two sets. We found a moderate correlation (ρ = 0.54, se = 0.02) between the variables in the second canonical variate, however, the value is not statistically significant (p = 0.68). Our results also show that a very small amount of the variation in the symptom sets is explained by the exposure variables. This indicates that host factors, rather than environmental factors might be important towards understanding the etiology of encephalitis and facilitate early diagnosis and treatment of encephalitis patients.ConclusionsThere is no standard laboratory diagnostic strategy for investigation of encephalitis and even experienced physicians are often uncertain about the cause, appropriate therapy and prognosis of encephalitis. Exploration of human encephalitis data using advanced multivariate statistical modelling approaches that can capture the inherent complexity in the data is, therefore, crucial in understanding the causes of human encephalitis. Moreover, application of multivariate exploratory techniques will generate clinically important hypotheses and offer useful insight into the number and nature of variables worthy of further consideration in a confirmatory statistical analysis.

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Encephalitis in children: A clinical neuropsychology perspective

Cited by 5 publications

References 23 publications

Neurotropic mechanisms in COVID-19 and their potential influence on neuropsychological outcomes in children

Neurotropic mechanisms in COVID-19 and their potential influence on neuropsychological outcomes in children

Chronic pediatric medical conditions and comorbid psychopathology.

Potential risk factors associated with human encephalitis: application of canonical correlation analysis

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