Systematic review of rehabilitation intervention outcomes of adult and paediatric patients with infectious encephalitis

Abstract

ObjectiveAlthough a range of rehabilitation interventions have been applied to restore function after infectious encephalitis, there is a lack of literature summarising the benefits of these interventions. This systematic review aims to synthesise current scientific knowledge on outcome measures following rehabilitative interventions among children and adults with infectious encephalitis, with a specific focus on the influence of the age, sex, baseline status and intervention type.Search strategyFive scholarly databases (MEDLINE, Embase, PsycINFO, CINAHL and Cochrane Central Register of Controlled Trials), three sources of grey literature (Google, Google Scholar and Grey Matters) and reference lists of included publications were systematically searched. Literature published before 15 December 2017 and focused on patients with infectious encephalitis in any rehabilitation setting were included. Quality assessment was completed using the Downs and Black rating scale.ResultsOf the 12 737 reference titles screened, 20 studies were included in this review. All of the studies had sample sizes of less than 25 patients and received a score of less than 15 out of 31 points on the Downs and Black rating scale. Findings showed a variety of interventions has been applied to alleviate sequelae from infectious encephalitis, including using cognitive therapy (nine studies), behavioural therapy (five studies), physical therapy (two studies) or two or more therapies (four studies). There was inconclusive evidence on the effect of sex, age and baseline functional abilities on outcomes. Due to clinical and methodological heterogeneity between studies, meta-analyses were not performed.ConclusionEvidence suggests the potential for a beneficial effect of rehabilitation interventions in patients with infectious encephalitis. Future research is required to identify all effect modifiers and to determine the effect of time in the natural course of recovery. An enhanced set of known effect modifiers will support the process of future evaluation of a client-centred rehabilitation intervention.Trial registration numberCRD42015029217.

Therapeutic difficulties in vegetative epileptic seizures as a sign of acute viral encephalitis: case presentation

“…In our case, patient's behavior status, anxiety and cephalalgy are mandatory to be monitor in the future visits. The quality of the rehabilitation care is not dependent of age, sex, type of infectious agent or intervention type, but is related more to establishing the correct diagnosis, the initial clinical picture, as well as the unique central nervous system characteristics of each individual (6). The particularities of this case lay in the atypical symptomatology of encephalitis manifested through headache, without the alteration of the conscious state or other neurological signs, vegetative epileptic crisis manifested through high blood pressure, associated with cortical laminar necrosis and in the fact that the pathogen agent wasn't detected through the currently available methods.…”

“…Some of the chronic deficits that the patient may experience include neurological impairments, movement disorders, aphasia, behavioral abnormalities, and intellectual deficit. The general outcome can be improved by rehabilitation methods which can be applied according to each case particularity (6). Cognitive therapy interventions, measuring for example memory and language processing, have a positive change in neuropsychological tests from baseline to follow-up, but with no complete recovery for the majority of patients.…”

“…Behavioral therapy methods following infectious encephalitis also show an improved result. Physical therapy interventions are very important in improving motor and sensory deficits, with lower need of assistance for daily life activities (6). The combination of physical, psychological, occupational and speech therapy plays a major role in the rehabilitation of these patients, and studies reveal a significant improvement in scores, but with incomplete recovery for some patients (6).…”

Outcomes of neuroinfections and their predictors

“…Для смягчения последствий инфекционного энцефалита применялись различные вмешательства, в том числе с использованием когнитивной терапии (9 исследований), поведенческой терапии (5 исследований), физиотерапии (2 исследования) или 2 или более методов лечения (4 исследования). Из-за их клинической и методологической неоднородности метаанализ не проводился [11].…”

The Importance of Comprehensive Neuropsychiatric Care in the Postencephalitic Patient

“…Rehabilitative treatment modalities should be considered in this population, as there is the potential for at least partial recovery [3]. A prospective evaluation of cognitive recovery across encephalitis subtypes showed that the majority improved over time [4].…”