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DOI: 10.1055/a-2735-0911
Evaluation of Demographic, Clinical, and Electroencephalographic Findings in Pediatric Patients Followed Up for Multisystem Inflammatory Syndrome in Children
Auswertung demografischer, klinischer und EEG-Befunde bei pädiatrischen Patienten, die wegen MIS-C nachbeobachtet wurdenAuthors
Abstract
Purpose
Multisystem inflammatory syndrome in children emerged as a result of the COVID-19 pandemic and has been reported to cause many different symptoms. We aimed to evaluate the electroencephalographic findings as well as the neurological manifestations of children, followed up with multisystem inflammatory syndrome in children in comparison with healthy controls.
Methods
Children who were diagnosed with multisystem inflammatory syndrome between March 2020 and 2022 were included. The demographic characteristics of the patients, complaints, electroencephalographic findings, and follow-ups were examined.
Results
Seventy patients, with a mean age of 108 (±47.7) months and 44 (62.9%) males, were included in the study. Multisystem inflammatory syndrome in children was divided into three categories based on severity:mild (n=41; 58.5%), moderate (n=24; 34.2%), and severe (n=5; 7.1%). At least one neurological symptom was present in 51 (72%) of cases. Table 1 lists the admission grievances. Electroencephalographic recordings were made for all patients in terms of sleep and wakefulness. Electroencephalographic abnormalities were detected in 20 (28.6%) patients (n=2 generalized and n=18 focal paroxysmal activity). Six weeks later, patients with abnormal electroencephalographic patterns underwent imaging and a control electroencephalography. Generalized epileptiform activity was detected in two patients on electroencephalography, but the patients had normal cranial magnetic resonance imaging and no neurological deficit was found. Of these 20 patients,12 had neurological manifestations, and 8 were asymptomatic.
Conclusions
This study provides an in-depth evaluation of neurological findings in multisystem inflammatory syndrome in children and includes one of the largest case series on electroencephalographic findings available in the literature. The results highlight the significance of electroencephalographic abnormalities in multisystem inflammatory syndrome in patients, emphasizing the need for close neurological monitoring.
Zusammenfassung
Zweck
Das multisystemische Entzündungssyndrom bei Kindern(MIS-C)entstand infolge der COVID-19-Pandemie und wurde mit vielen Symptomen in Verbindung gebracht.Wir wollten EEG-Befunde sowie die neurologischen Manifestationen von Kindern mit MIS-C im Vergleich zu gesunden Kontrollen zu evaluieren.
Methoden
Kinder,die zwischen März 2020-2022 mit MIS-C diagnostiziert wurden,wurden eingeschlossen.Demografische Merkmale,Beschwerden,EEG-Befunde und Verläufe wurden untersucht.
Ergebnisse
Insgesamt wurden 70 Patienten,im Durchschnitt 108(±47,7)Monate alt,44(62,9%)männlich,eingeschlossen.MIS-C wurde nach Schweregrad in mild(n=41;58,5%),moderat(n=24;34,2%)und schwer(n=5;7,1%)eingeteilt.Mindestens ein neurologisches Symptom zeigte sich bei 51(72%)Fällen.Tabelle1 zeigt die Beschwerden bei Aufnahme.EEGs wurden im Schlaf-und Wachzustand durchgeführt.EEG-Anomalien wurden bei 20(28,6%)Patienten(n=2 generalisiert,n=18 fokale paroxysmale Aktivität)festgestellt.Nach 6 Wochen wurden bei Patienten mit abnormalem EEG Bildgebung und Kontroll-EEG durchgeführt.Generalisiert epileptiforme Aktivität wurde bei 2 Patienten festgestellt,aber die MRT-Ergebnisse waren normal und es gab keine neurologischen Defizite.Von diesen 20 Patienten hatten 12 neurologische Symptome,8 waren asymptomatisch.
Fazit
Diese Studie bietet eine detaillierte Bewertung neurologischer Befunde bei MIS-C und umfasst eine der größten Fallserien zu EEG-Befunden.Die Ergebnisse betonen die Bedeutung von EEG-Anomalien und die Notwendigkeit enger neurologischer Überwachung.
Publication History
Received: 30 December 2024
Accepted after revision: 29 October 2025
Article published online:
27 November 2025
© 2025. Thieme. All rights reserved.
Georg Thieme Verlag KG
Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany
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References
- 1 Martins MM, Prata-Barbosa A, da Cunha AJLA. Update on SARS-CoV-2 infection in children. Paediatr Int Child Health 41 2021; (01) 56-64
- 2 Panigrahy N, Policarpio J, Ramanathan R. Multisystem inflammatory syndrome in children and SARS-CoV-2: A scoping review. Pediatr Rehabil Med 2020; 13 (03) 301-316
- 3 Loke Y-HY-H, Berul CICI, Harahsheh ASAS. Multisystem inflammatory syndrome in children: is there a linkage to Kawasaki disease?. Trends Cardiovasc Med 2020; 30: 389-396
- 4 WHO e World Health Organization. Multisystem inflammatory syndrome in children and adolescents temporally related to COVID-19 https://www.who.int/news-room/commentaries/detail/multisystem-inflammatorysyndrome-in-children-and-adolescents-with-covid-19
- 5 Olivotto S, Basso E, Lavatelli R. et al. Acute encephalitis in pediatric multisystem inflammatory syndrome associated with COVID-19. Eur J Paediatr Neurol 2021; 34: 84e90
- 6 Riphagen S, Gomez X, Gonzalez-Martinez C. et al. Hyperinflammatory shock in children during COVID-19 pandemic. Lancet 2020; 395: 1607-1608
- 7 Kısaarslan AP, Baykan A, Akyıldız BN, Poyrazoglu H. Erciyes clinical guideline for multisystem ınflammatory syndrome ın children (MIS-C) associated With COVID-19. J Pediatr Acad. 3. 04 1-8 2022
- 8 Licciardi F, Pruccoli G, Denina M. et al. SARS-CoV-2 induced kawasaki-like hyperinflammatory syndrome: a novel COVID phenotype in children. Pediatrics 2020; 146 (02) e20201711 Epub 2020 May 21
- 9 Romero-Sánchez CM, Díaz-Maroto I, Fernández-Díaz E. Neurologic manifestations in hospitalized patients with COVID-19: The ALBACOVID registry. Neurology 2020; 95 (08) e1060 Epub 2020 Jun 1
- 10 Panda PK, Sharawat IK, Panda P. et al. Neurological complications of SARS-CoV-2 infection in children: a systematic review and meta-analysis. J Trop Pediatr 2020; 65: fmaa070
- 11 Esposito S., Principi N. Multisystem Inflammatory Syndrome in Children Related to SARS-CoV-2. Pediatr Drugs 2021; 23: 119-129
- 12 Dufort EM, Koumans EH, Chow EJ. et al. Multisystem inflammatory syndrome in children in New York State. N Engl J Med 2020; 383 (04) 347 Epub 2020 Jun 29.
- 13 Whittaker E, Bamford A, Kenny J. et al. Clinical characteristics of 58 children with a pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2. JAMA 2020; 324 (03) 259
- 14 Kaushik A, Gupta S, Sood M. et al. A systematic review of multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection. Pediatr Infect Dis J 2020; 39 (11) e340
- 15 Radia T, Williams N, Agrawal P. et al. Multi-system inflammatory syndrome in children&adolescents (MIS-C): A systematic review of clinical features and presentation. Paediatr Respir Rev 2020; 38: 51-57
- 16 Cirks BT, Rowe SJ, Jiang SY. et al. 16 Weeks later: expanding the risk period for MIS-C. J Pediatric Infect Dis Soc 2021; 10: 686-690
- 17 Abdel-Mannan O, Eyre M, Löbel U. et al. Neurologic and Radiographic Findings Associated With COVID-19 Infection in Children. JAMA Neurol 2020; 77 (11) 1440-1445
- 18 Bova SM, Serafini L, Capetti P. et al. Neurological involvement in multisystem inflammatory syndrome in children: clinical, electroencephalographic and magnetic resonance imaging peculiarities and therapeutic implications. an italian single-center experience. Front Pediatr 2022; 10: 932208
- 19 LaRovere KL, Riggs BJ, Poussaint TY. et al. Neurologic involvement in children and adolescents hospitalized in the United States for COVID-19 or multisystem inflammatory syndrome. JAMA Neurol 2021; 78 (05) 536
- 20 Angurana SK, Awasthi P, Thakur A. et al. Intensive care needs and short-term outcome of multisystem inflammatory syndrome in children (MIS-C): experience from North India. J Trop Pediatr 2021; 67 (03) fmab055
- 21 Sa M, Mirza L, Carter M. et al. Systemic inflammation is associated with neurologic involvement in pediatric inflammatory multisystem syndrome associated with SARS-CoV-2. Neurol Neuroimmunol Neuroinflamm 2021; 8 (04) e999
- 22 Kabeerdoss J, Pilania RK, Karkhele R. et al. Severe COVID-19 multisystem inflammatory syndrome in children, and Kawasaki disease: immunological mechanisms. Clinical manifestations and management. Rheumatol Int 2020; 21: 1-14
- 23 Nepal G, Shrestha GS, Rehrig JH. et al. Neurological manifestations of COVID-19 associated multi-system inflammatory syndrome in children: a systematic review and meta-analysis. J Nepal Health Res Counc 2021; 19 (01) 10-18
- 24 Verrotti A, Mazzocchetti C, Iannetti P. Definitive pathognomonic signs and symptoms of paediatric neurological COVID-19 are still emerging. Acta Paediatr 2021; 110 (06) 1774-1777
- 25 Dugue R, Cay-Martinez KC, Thakur KT. et al. Neurologic manifestations in infant with Covid-19. Neurology 2020; 94: 1100-1102
- 26 Martinez-Valderrama A, Myers KA. Electroencephalographic patterns in pediatric patients with multisystem inflammatory syndrome in children and coronavirus disease 2019 coinfection. Pediatr Neurol 2023; 149: 114-119
- 27 Dehghan A, Saleh R, Rahimi H. et al. Acute neurological symptoms in multisystem inflammatory syndrome in children: A case series. Heliyon 2023; 9 (08) e18566
