Neuropediatrics 2006; 37 - MP16
DOI: 10.1055/s-2006-943613

ON THE LONG-TERM PROGNOSIS OF JAPANESE ENCEPHALITIS – THE RETROSPECTIVE ANALYSIS OF PATIENTS WITH SEQUELA OF JAPANESE ENCEPHALITIS

Y Anzai 1, M Hayashi 1, T Ohya 1
  • 1Department of Pediatrics, National Rehabilitation Center for Disabled Children, Itabashi-ku, Tokyo, Japan

Objectives: Japanese encephalitis (JE) still prevails in Asian countries with serious problems. In Japan, its occurrence is very rare due to success of vaccination. However, handicapped patients with its sequela are admitted in the institutions for severe motor and intellectual disabilities (SMID), and the long-term prognosis and characteristics have not been well known. Present object is to report the neurological states of institutionalized patients with sequela of JE (sJE) and clarify longterm prognosis of JE.

Methods: A questionnaire on patients with sJE was sent to five child rehabilitation centers and 21 institutions for SMID around the Kanto district. The questionnaire consisted of inquiries regarding age of onset, viral and/or serological study and severities of developmental delay, epileptic seizures, involuntary movements and systemic complications.

Results: 22 of 26 facilities returned answers, including 23 patients with sJE, which aged from 36 to 77 years. The onset age of JE was under 10 years in 22 patients and at 20 years in one patient. No viral or serological study was performed in all subjects, which were clinically diagnosed as JE. One patient could converse, whereas the others had no speech. 17 patients held sitting and 7 of 17 could walk without support. 18 patients were on anticonvulsants, 3 of which have been difficult in control. One subject each demonstrated oral dyskinesia and laryngeal dystonia, respectively. 14 and 4 patients had swallowing difficulty and disturbed bladder control, respectively, although none developed respiratory failure. MRI films, being confirmed in three patients, demonstrated pallidal changes, frontal cortical atrophy and encephaloclasia after putaminal hemorrhage, respectively.

Conclusion: Our SMID patients with sJE revealed swallowing difficulty and disturbed bladder control but not respiratory disturbances. Interestingly, the number of patients showing involuntary movements was comparatively low. The retrospective analysis of patients with sJE will give us a clue for clarifying pathogenesis of JE.