MarÃa De Ceano-Vivas (Spain)
Hospital Universitario La Paz Urgencias PediátricasAuthor Of 1 Presentation
NEURODEVELOPMENTAL OUTCOMES OF YOUNG INFANTS FOLLOWING ENTEROVIRAL AND PARECHOVIRAL INFECTIONS OF THE CENTRAL NERVOUS SYSTEM
Abstract
Backgrounds:
Enteroviruses (EVs) and human parechoviruses (HPeVs) are a major cause of CNS infection in young infants. They have been implicated in neurodevelopmental delay, limited data are available. The aim of this study is to describe clinical outcome and to assess and compare medium-term neurodevelopment following EV and HPeV-CNS-infections.
Methods
A multicentre observational ambispective study was conducted between May-2013 and March-2018. Children under 3 months with EV or HPeV CNS-infection excluding encephalitis were included. Infants were contacted one year after acute infection. Their neurological development was evaluated using ASQ-3-test. If any area was abnormal during first round, a second round was completed later.
Results:
Forty-eight young infants with EV and HPeV CNS infection were identified: 33 (68.8%) EV and 15 (31.3%) HPeV. At first assessment 14/29 (48.3%) EV and 3/15 (20%) HPeV positive cases presented some developmental concern in the ASQ-3-test. EV-positive infants showed mild and moderate alteration in all domains analysed and HPeV-positive infants showed mild alterations only in gross and fine motor domains. Significant alterations in communication were observed in EV-positive but not in HPeV-positive infants (p=0.016). At second assessment 4/13 (30.8%) EV-positive patients showed mild to moderate concerns in communication and gross motor function and 3/13 (23.1%) showed significant concern in fine motor function.
Conclusions/Learning Points:
Although CNS infections without associated encephalitis are generally assumed to be benign our study shows that at a median age of 18 months, 48.3% of the EV-infected infants and 20% of HPeV-positive infants presented some developmental concern in the ASQ-3-test. We recommend monitor neurological development of infants during the first years of life after HPeV CNS infection and especially after EV CNS infection, even in mild cases, for an early intervention and stimulation if necessary.