Kognitive Langzeitfolgen nach einer akuten Enzephalitiseine

Abstract

Akute Enzephalitiden sind seltene Erkrankungen. Es existieren nur wenige Untersuchungen bezüglich der kognitiven Langzeiterholung dieser Patienten. Nachfolgende neuropsychologische Studie untersuchte prospektiv kognitive Langzeitfolgen in Patienten nach einer durchgemachten akuten Enzephalitis und verglich sie mit Alters- Geschlechts- und Bildungsgematchten Kontrollpersonen. Die Zeit zwischen Untersuchung und Akutereignis betrug 6 – 93 Monate. Die Ergebnisse zeigten in der Mehrzahl eine positive kognitive Erholung. Im Vordergrund standen unabhängig von der Ätiologie der Enzephalitis Störungen des Antriebs und der Exekutivfunkionen. Eine postenzephalitische Epilepsie erwies sich als negativer Risikofaktor für die kognitive Rehabilitation.

Cognitive Impairment After Acute Encephalitis: An ERP Study

“…Kalita et al conducted the ERPs 1-84 months (median 3 months) after the acute event compared to 6-84 months (median 43 months, mean 39 months) in our population. In a previous analysis, we found out that cognitive recovery takes places mainly during the first 6 (up to 13) months [8]. Therefore part of the difference might be explained by the time.…”

“…We found no significant difference in the latencies of the P3 between patients after unselected sporadic encephalitis and a healthy age-matched control group. This may indicate a good cognitive recovery as we have proposed earlier [8]. However, selection bias is surely a limiting factor, because we only investigated patients who were able to attend our outpatient-department for investigation and patients with much more severe courses of the disease were probably lost to follow-up.…”

“…Patients identified through this retrospective analysis received invitations to undertake a comprehensive neuropsychological exam [8], structured interview and to fill in questionnaires regarding their quality of life [11], cranial MRI [12], and event related potential between December 1999 and October 2000. This study was approved by the ethic committee and has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.…”

“…The adaptation of this scale [11] was necessary because to our knowledge (at the time the study was performed), no encephalitis-specific scales or scores for judging disability existed. For statistical evaluation, we classified the patients as having "favorable outcome" (rank 0-2 on the encephalitis-adapted MRS, independence not impaired) or "unfavorable outcome (rank 3-5, partial or complete dependence in activities of daily living) [8,11]. During the interview, patients were also evaluated for post-encephalitic epilepsy.…”

“…We recently published data about the cognitive longterm outcome in patients 6-93 months after the acute event of encephalitis assessed by a comprehensive neuropsychological exam and found impairment of execution and motivation functions that were independent of the etiology of encephalitis [8]. Postencephalitis epilepsy had a negative effect on cognitive rehabilitation in this group.…”