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Acta Ophthalmol. 2017 Feb;95(1):66-73. doi: 10.1111/aos.13305. Epub 2016 Dec 14.

Ophthalmological findings in children with encephalitis.

Author information

1
Department of Neuropediatrics, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden.
2
Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
3
Neuropediatric Unit, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

Abstract

PURPOSE:

To evaluate ophthalmological abnormalities in children with acute encephalitis.

METHODS:

Thirty-six children included in a hospital-based prospectively and consecutively collected cohort of children with acute encephalitis were investigated for ophthalmological abnormalities. The investigation included clinical ophthalmological examination, fundus photography, neuro-ophthalmological examinations as well as visual and stereo acuity. Results on laboratory examinations, clinical findings, neuroimaging and electroencephalography registrations were recorded for all children.

RESULTS:

The median age was 4.0 years (Interquartile Range 1.9-9.8). The aetiology was identified in 74% of cases. Three of 36 patients were found to have abnormal ophthalmological findings related to the encephalitis. Transient sixth nerve palsy was seen in a 15-year-old child and transient visual impairment was seen in a 3.5-year-old child. Bilateral miosis and ptosis, i.e. autonomic nerve system symptoms, were seen in an 11-month-old child, with herpes simplex 1 and N-methyl-d-aspartate receptor antibody encephalitis. All three children recovered and improved their ophthalmological function with time.

CONCLUSION:

Only 3 of 36 children were found to have ophthalmological abnormalities due to encephalitis and they all improved with time. Thus, ophthalmological consultation does not seem to fit in a screening programme for childhood encephalitis but should be considered in selected cases.

KEYWORDS:

central nervous system; infection; neurological; ophthalmological outcome; paediatric

PMID:
27966268
DOI:
10.1111/aos.13305
[Indexed for MEDLINE]
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