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Clinical Outcome and Life Quality of Patients After Monophasic Encephalitis

Hahn, Katrin MD*; Schildmann, Eva MD; von Seggern, Isabell MD; Kratzer, Christine MD§; Dietz, Ekkehard PhD; Schielke, Eva MD

Infectious Diseases in Clinical Practice: September 2010 - Volume 18 - Issue 5 - p 313-317
doi: 10.1097/IPC.0b013e3181e85cec
Original Articles

Purpose: Acute encephalitis is a rare disease mainly occurring sporadically. Only limited data as to the long-term prognosis, in particular for impact on quality of life, is available.

Methods: Patients with a definite or highly probable diagnosis of acute encephalitis were identified through retrospective analysis and invited to undertake a structured interview and to fill in questionnaires regarding their quality of life. People who matched the patients in age, sex, and level of education were used as controls.

Results: Seventy-two patients and 57 controls were included. The period between the acute illness and the follow-up amounted to 6 to 93 months. The study showed a favorable outcome with complete or far-reaching functional recovery in most of the patients (83.3%). In cases that progressed in an unfavorable way such that cognitive handicaps were dominant, only 4% were left with extreme physical handicaps. Approximately 22% had postencephalitic epilepsy, which was correlated to a significantly more unfavorable outcome (P < 0.05). Women who have had encephalitis were significantly more depressive than men (P < 0.001) and also noticeably more depressive than female control subjects (P < 0.01). Furthermore, postencephalitic epilepsy was linked with significantly stronger likelihood of depression (P < 0.05).

Conclusions: In this study, most patients had a favorable outcome with complete or far-reaching functional recovery. Postencephalitic epilepsy is a risk factor for an unfavorable outcome and a factor that might hinder coping with the sequelae of acute encephalitis in the long term and that has a negative effect on mood.

From the *Department of Neurology, Universitätsmedizin Charité; †Department of Haematology, Oncology and Tumour Immunology, Robert-Rössle-Klinik, Helios Klinikum Berlin-Buch; ‡Departments of Traumatology and Orthopedics, DRK-Klinikum Köpenick Berlin; §Medical Practice; ∥Institutes of Biometry/Clinical Epidemiology, Universitätsmedizin Charité; and ¶Neurological Practice, Berlin, Germany.

Correspondence to: Katrin Hahn, MD, Department of Neurology, University Medicine, Charité, Campus Mitte, Charitéplatz 1, 10117 Berlin, Germany. E-mail:

The authors have no funding or conflicts of interest to disclose.

© 2010 Lippincott Williams & Wilkins, Inc.