Neurodevelopment and cognition in children after enterovirus 71 infection

Luan Yin Chang, Li Min Huang, Susan Shur Fen Gau, Yu Yu Wu, Shao Hsuan Hsia, Tsui Yen Fan, Kuang Lin Lin, Yhu Chering Huang, Chun Yi Lu, Tzou Yien Lin

研究成果: 雜誌貢獻文章

228 引文 (Scopus)

摘要

Background: Enterovirus 71 is a common cause of hand, foot, and mouth disease and encephalitis in Asia and elsewhere. The long-term neurologic and psychiatric effects of this viral infection on the central nervous system (CNS) are not well understood. Methods: We conducted long-term follow-up of 142 children after enterovirus 71 infection with CNS involvement - 61 who had aseptic meningitis, 53 who had severe CNS involvement, and 28 who had cardiopulmonary failure after CNS involvement. At a median follow-up of 2.9 years (range, 1.0 to 7.4) after infection, the children received physical and neurologic examinations. We administered the Denver Developmental Screening Test (DDST II) to children 6 years of age or younger and the Wechsler intelligence test to children 4 years of age or older. Results: Nine of the 16 patients with a poliomyelitis-like syndrome (56%) and 1 of the 5 patients with encephalomyelitis (20%) had sequelae involving limb weakness and atrophy. Eighteen of the 28 patients with cardiopulmonary failure after CNS involvement (64%) had limb weakness and atrophy, 17 (61%) required tube feeding, and 16 (57%) required ventilator support. Among patients who underwent DDST II assessment, delayed neurodevelopment was found in only 1 of 20 patients (5%) with severe CNS involvement and in 21 of 28 patients (75%) with cardiopulmonary failure (P<0.001 for the overall comparison). Children with cardiopulmonary failure after CNS involvement scored lower on intelligence tests than did children with CNS involvement alone (P = 0.003). Conclusions: Enterovirus 71 infection with CNS involvement and cardiopulmonary failure may be associated with neurologic sequelae, delayed neurodevelopment, and reduced cognitive functioning. Children with CNS involvement without cardiopulmonary failure did well on neurodevelopment tests.
原文英語
頁(從 - 到)1226-1234
頁數9
期刊New England Journal of Medicine
356
發行號12
DOIs
出版狀態已發佈 - 三月 22 2007
對外發佈Yes

指紋

Enterovirus Infections
Cognition
Central Nervous System
Intelligence Tests
Nervous System
Atrophy
Central Nervous System Viral Diseases
Extremities
Hand, Foot and Mouth Disease
Aseptic Meningitis
Encephalomyelitis
Enterovirus
Neurologic Examination
Enteral Nutrition
Poliomyelitis
Encephalitis
Mechanical Ventilators
Physical Examination
Psychiatry

ASJC Scopus subject areas

  • Medicine(all)

引用此文

Chang, L. Y., Huang, L. M., Gau, S. S. F., Wu, Y. Y., Hsia, S. H., Fan, T. Y., ... Lin, T. Y. (2007). Neurodevelopment and cognition in children after enterovirus 71 infection. New England Journal of Medicine, 356(12), 1226-1234. https://doi.org/10.1056/NEJMoa065954

Neurodevelopment and cognition in children after enterovirus 71 infection. / Chang, Luan Yin; Huang, Li Min; Gau, Susan Shur Fen; Wu, Yu Yu; Hsia, Shao Hsuan; Fan, Tsui Yen; Lin, Kuang Lin; Huang, Yhu Chering; Lu, Chun Yi; Lin, Tzou Yien.

於: New England Journal of Medicine, 卷 356, 編號 12, 22.03.2007, p. 1226-1234.

研究成果: 雜誌貢獻文章

Chang, LY, Huang, LM, Gau, SSF, Wu, YY, Hsia, SH, Fan, TY, Lin, KL, Huang, YC, Lu, CY & Lin, TY 2007, 'Neurodevelopment and cognition in children after enterovirus 71 infection', New England Journal of Medicine, 卷 356, 編號 12, 頁 1226-1234. https://doi.org/10.1056/NEJMoa065954
Chang, Luan Yin ; Huang, Li Min ; Gau, Susan Shur Fen ; Wu, Yu Yu ; Hsia, Shao Hsuan ; Fan, Tsui Yen ; Lin, Kuang Lin ; Huang, Yhu Chering ; Lu, Chun Yi ; Lin, Tzou Yien. / Neurodevelopment and cognition in children after enterovirus 71 infection. 於: New England Journal of Medicine. 2007 ; 卷 356, 編號 12. 頁 1226-1234.
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title = "Neurodevelopment and cognition in children after enterovirus 71 infection",
abstract = "Background: Enterovirus 71 is a common cause of hand, foot, and mouth disease and encephalitis in Asia and elsewhere. The long-term neurologic and psychiatric effects of this viral infection on the central nervous system (CNS) are not well understood. Methods: We conducted long-term follow-up of 142 children after enterovirus 71 infection with CNS involvement - 61 who had aseptic meningitis, 53 who had severe CNS involvement, and 28 who had cardiopulmonary failure after CNS involvement. At a median follow-up of 2.9 years (range, 1.0 to 7.4) after infection, the children received physical and neurologic examinations. We administered the Denver Developmental Screening Test (DDST II) to children 6 years of age or younger and the Wechsler intelligence test to children 4 years of age or older. Results: Nine of the 16 patients with a poliomyelitis-like syndrome (56{\%}) and 1 of the 5 patients with encephalomyelitis (20{\%}) had sequelae involving limb weakness and atrophy. Eighteen of the 28 patients with cardiopulmonary failure after CNS involvement (64{\%}) had limb weakness and atrophy, 17 (61{\%}) required tube feeding, and 16 (57{\%}) required ventilator support. Among patients who underwent DDST II assessment, delayed neurodevelopment was found in only 1 of 20 patients (5{\%}) with severe CNS involvement and in 21 of 28 patients (75{\%}) with cardiopulmonary failure (P<0.001 for the overall comparison). Children with cardiopulmonary failure after CNS involvement scored lower on intelligence tests than did children with CNS involvement alone (P = 0.003). Conclusions: Enterovirus 71 infection with CNS involvement and cardiopulmonary failure may be associated with neurologic sequelae, delayed neurodevelopment, and reduced cognitive functioning. Children with CNS involvement without cardiopulmonary failure did well on neurodevelopment tests.",
author = "Chang, {Luan Yin} and Huang, {Li Min} and Gau, {Susan Shur Fen} and Wu, {Yu Yu} and Hsia, {Shao Hsuan} and Fan, {Tsui Yen} and Lin, {Kuang Lin} and Huang, {Yhu Chering} and Lu, {Chun Yi} and Lin, {Tzou Yien}",
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T1 - Neurodevelopment and cognition in children after enterovirus 71 infection

AU - Chang, Luan Yin

AU - Huang, Li Min

AU - Gau, Susan Shur Fen

AU - Wu, Yu Yu

AU - Hsia, Shao Hsuan

AU - Fan, Tsui Yen

AU - Lin, Kuang Lin

AU - Huang, Yhu Chering

AU - Lu, Chun Yi

AU - Lin, Tzou Yien

PY - 2007/3/22

Y1 - 2007/3/22

N2 - Background: Enterovirus 71 is a common cause of hand, foot, and mouth disease and encephalitis in Asia and elsewhere. The long-term neurologic and psychiatric effects of this viral infection on the central nervous system (CNS) are not well understood. Methods: We conducted long-term follow-up of 142 children after enterovirus 71 infection with CNS involvement - 61 who had aseptic meningitis, 53 who had severe CNS involvement, and 28 who had cardiopulmonary failure after CNS involvement. At a median follow-up of 2.9 years (range, 1.0 to 7.4) after infection, the children received physical and neurologic examinations. We administered the Denver Developmental Screening Test (DDST II) to children 6 years of age or younger and the Wechsler intelligence test to children 4 years of age or older. Results: Nine of the 16 patients with a poliomyelitis-like syndrome (56%) and 1 of the 5 patients with encephalomyelitis (20%) had sequelae involving limb weakness and atrophy. Eighteen of the 28 patients with cardiopulmonary failure after CNS involvement (64%) had limb weakness and atrophy, 17 (61%) required tube feeding, and 16 (57%) required ventilator support. Among patients who underwent DDST II assessment, delayed neurodevelopment was found in only 1 of 20 patients (5%) with severe CNS involvement and in 21 of 28 patients (75%) with cardiopulmonary failure (P<0.001 for the overall comparison). Children with cardiopulmonary failure after CNS involvement scored lower on intelligence tests than did children with CNS involvement alone (P = 0.003). Conclusions: Enterovirus 71 infection with CNS involvement and cardiopulmonary failure may be associated with neurologic sequelae, delayed neurodevelopment, and reduced cognitive functioning. Children with CNS involvement without cardiopulmonary failure did well on neurodevelopment tests.

AB - Background: Enterovirus 71 is a common cause of hand, foot, and mouth disease and encephalitis in Asia and elsewhere. The long-term neurologic and psychiatric effects of this viral infection on the central nervous system (CNS) are not well understood. Methods: We conducted long-term follow-up of 142 children after enterovirus 71 infection with CNS involvement - 61 who had aseptic meningitis, 53 who had severe CNS involvement, and 28 who had cardiopulmonary failure after CNS involvement. At a median follow-up of 2.9 years (range, 1.0 to 7.4) after infection, the children received physical and neurologic examinations. We administered the Denver Developmental Screening Test (DDST II) to children 6 years of age or younger and the Wechsler intelligence test to children 4 years of age or older. Results: Nine of the 16 patients with a poliomyelitis-like syndrome (56%) and 1 of the 5 patients with encephalomyelitis (20%) had sequelae involving limb weakness and atrophy. Eighteen of the 28 patients with cardiopulmonary failure after CNS involvement (64%) had limb weakness and atrophy, 17 (61%) required tube feeding, and 16 (57%) required ventilator support. Among patients who underwent DDST II assessment, delayed neurodevelopment was found in only 1 of 20 patients (5%) with severe CNS involvement and in 21 of 28 patients (75%) with cardiopulmonary failure (P<0.001 for the overall comparison). Children with cardiopulmonary failure after CNS involvement scored lower on intelligence tests than did children with CNS involvement alone (P = 0.003). Conclusions: Enterovirus 71 infection with CNS involvement and cardiopulmonary failure may be associated with neurologic sequelae, delayed neurodevelopment, and reduced cognitive functioning. Children with CNS involvement without cardiopulmonary failure did well on neurodevelopment tests.

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