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Post-encephalitic epilepsy in childhood: results from a prospective cohort study Volume 23, numéro 1, February 2021

TEST YOURSELF

(1) The was a prospective study of patients with childhood encephalitis. Why was the risk of developing postencephalitic epilepsy lower in the present study in comparison to studies presented previously in the literature.

 

(2) How may the risk of post-encephalitic epilepsy be assessed using parameters estimated during the acute phase of the disease.

 

(3) What are the advantages and risks of using algorithms to estimate which children develop post-encephalitic epilepsy.

 

 

 

 

 

 

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Answers

(1) There are several reasons for the difference between the presented study and previously presented work in the literature. This study was done partly at a non-tertiary centre with an unbiased sampling of children with acute encephalitis approaching primary care. Several cases of very mild encephalitis were noted in this study with few or no long-term complications. A majority of published work has been done at tertiary centres where complicated cases collect, often with increased long term morbidity. Furthermore, this study represents the spectrum of acute encephalitis seen in Stockholm, Sweden where differences in aetiology in comparison to other published work could be another reason for differences in the estimated risk of developing PEE.

 

(2) This study found several parameters that could be assessed during the acute phase which would indicate an increased risk of developing PEE. Presence of acute seizures, epileptic activity on the EEG or new structural abnormalities on neuroimaging were associated with an increased risk of developing PEE.

 

(3) This answer is open and there are several possible advantages and disadvantages of using algorithms. They allow for quick assessment in acute settings and can also be used by a wider set of doctors and not only those specialising in epilepsy or inflammatory disorders affecting the brain. It also allows for consistent judgement of patients which can often vary between doctors when dealing with relatively rare disorders like PEE. Furthermore, any algorithm used would need to be calibrated against the patient cohort that is investigated as this study did show results that were different to other studies presented in the literature.

 

 

 

 

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