Neurological Outcomes Following Dengue Virus-Related Encephalitis in Pediatric Patients
Overview
This study evaluated long-term neurologic sequelae in 56 pediatric patients with dengue-associated acute encephalitis syndrome (DEN-AES). Neurologic sequelae were observed in 39.3% of cases, with cognitive and behavioral impairments being the most common. The findings highlight the need for early diagnosis and ongoing rehabilitation in dengue-endemic regions.
Background
Dengue virus (DENV) infection is a major global health concern with increasing recognition of its neurovirulence, especially following detection of the virus in cerebrospinal fluid. Dengue-associated acute encephalitis syndrome (DEN-AES) can lead to significant neurologic complications including seizures, altered mental status, and long-term disabilities. Pediatric populations in endemic regions, such as Eastern Uttar Pradesh, India, are particularly affected. Despite this, data on long-term neurologic outcomes after DEN-AES have been limited.
Data Highlights
Parameter
Value
Number of pediatric DEN-AES cases studied
56
Median age (years)
7.5 (IQR 5–10)
Male patients
53.6%
Patients with neurologic sequelae
22 (39.3%)
Severe disabilities
6 children
Postdischarge death
1 child
Fully recovered (Liverpool Outcome Score 5)
34 children
Patients with cognitive/behavioral impairments
37.5%
Patients requiring antiepileptic drugs
5 children
Key Findings
Neurologic sequelae were present in 39.3% of pediatric DEN-AES cases.
Cognitive and behavioral impairments were the most common sequelae, affecting 37.5% of patients.
Severe disabilities were observed in 6 children, including one postdischarge death.
Five children required ongoing antiepileptic treatment for seizure management.
Thirty-four children fully recovered with no residual disability (Liverpool Outcome Score of 5).
Neuroimaging in a representative case revealed encephalomalacic changes confirming structural brain damage.
Clinical Implications
Early recognition and diagnosis of dengue-associated encephalitis are critical to initiate timely management and reduce long-term neurologic sequelae. Continuous follow-up and use of standardized disability assessment tools can help identify children requiring rehabilitation and seizure management. Health systems in dengue-endemic regions should develop dedicated rehabilitation policies to support affected pediatric patients.
Conclusion
Dengue-associated acute encephalitis in children results in significant neurologic sequelae in nearly 40% of cases, predominantly cognitive and behavioral impairments. These findings emphasize the importance of early diagnosis, long-term monitoring, and rehabilitation to improve outcomes in pediatric DEN-AES.
References
Tropical and Emerging Infectious Diseases, Major Article, 2024 -- Neurological Outcomes Following Dengue Virus-Related Encephalitis in Pediatric Patients
