Chronic post-encephalitic epilepsy following Japanese encephalitis: Clinical features, neuroimaging data, and outcomes.
PURPOSE
Japanese encephalitis (JE), the main cause of viral encephalitis in Asia, usually presents with acute symptomatic seizures; however, there have been very few systematic reports regarding late unprovoked seizures and epilepsy. We aimed to describe the clinical features and outcomes of post-encephalitic epilepsy following JE.


METHODS
Patients with epilepsy with a previous confirmed diagnosis of JE visiting West China Hospital from 2013 to 2019 were enrolled in the observational case-controlled study. Patients with epilepsy with a history of other non-specific viral encephalitis were enrolled as controls. For all enrolled subjects, disease related information was recorded.


RESULTS
Forty-eight patients with JE (20 males; median age, 21.0 years; average epilepsy duration, 8.55 years) were identified. The median duration from JE to the first unprovoked seizure was 7.73 years, which significantly differed from that of the controls (7.73 vs. 2.69 years, respectively; p = 4.59 × 10-6). Most patients had focal epilepsy, and 29 (78.38%) were drug resistant. Among 45 patients with available neuroimaging data, three in fourth had no obvious abnormality, and the temporal lobe and hippocampus (22.22%) were the most affected brain regions. Six patients had surgery, and three achieved class-one seizure-free status.


CONCLUSION
The latency to the first unprovoked seizure was longer in patients with JE than controls. Regarding chronic epilepsy, three in four had structural abnormalities, and the long-term outcomes of post-encephalitic epilepsy following JE were poor. Surgery remains an option for drug-resistant epilepsy.
['Xiong|Weixi|W|', 'Lu|Lu|L|', 'Chen|Jiani|J|', 'Xiao|Yingfeng|Y|', 'Zhou|Dong|D|']
D000293:Adolescent D000328:Adult D016022:Case-Control Studies D002681:China D000078332:Data Analysis D004672:Encephalitis, Japanese D004827:Epilepsy D005260:Female D006801:Humans D008297:Male D059906:Neuroimaging D016896:Treatment Outcome D055815:Young Adult
Japanese encephalitis Seizure Post-encephalitc epilepsy