Neurologic Sequelae After Encephalitis Associated With Dengue Virus in Children
By
Neha Srivastava
Rakesh Mankal
Rohit Beniwal
Aman Agarwal
Umaer Alam
Ashok Kumar Pandey
Rajni Kant
Mahima Mittal
September 10, 2025
Clinical Scorecard: Neurological Outcomes Following Dengue Virus-Related Encephalitis in Pediatric Patients
At a Glance
Category Detail
Condition Dengue-associated acute encephalitis syndrome (DEN-AES) in children Key Mechanisms Dengue virus neurovirulence confirmed by PCR detection in cerebrospinal fluid causing encephalitis and subsequent neurologic sequelae Target Population Pediatric patients aged ≤18 years with confirmed dengue-associated acute encephalitis Care Setting Tertiary care hospital and home-based follow-up in dengue-endemic regions
Key Highlights
Neurologic sequelae observed in 39.3% of pediatric DEN-AES cases, including severe disabilities and postdischarge death Cognitive and behavioral impairments were the most common long-term sequelae (37.5%) Early diagnosis, continuous follow-up, and dedicated rehabilitation are critical to support affected children Guideline-Based Recommendations
Diagnosis
Confirm dengue infection using NS1/IgM ELISA and reverse transcription polymerase chain reaction tests Define AES by acute fever with altered mental status and/or new seizures excluding simple febrile seizures Management
Provide supportive care during acute encephalitis phase Use antiepileptic drugs for ongoing seizure management when indicated Monitoring & Follow-up
Conduct long-term follow-up assessments using standardized disability tools Monitor cognitive, behavioral, and neurological function postdischarge Risks
Risk of severe neurologic sequelae including cognitive impairment, behavioral issues, and physical disabilities Potential for postdischarge mortality in severe cases Patient & Prescribing Data
Children aged ≤18 years hospitalized with dengue-associated acute encephalitis
Five children required antiepileptic drugs for seizure control postdischarge; rehabilitation needs vary by severity of sequelae
Clinical Best Practices
Early identification of dengue-associated encephalitis using combined clinical and laboratory criteria Implement continuous and structured follow-up to detect and manage neurologic sequelae Develop and apply rehabilitation policies tailored for pediatric dengue encephalitis survivors in endemic regions References
