Tick-borne encephalitis in Styrian children from 1981 to 2005: a retrospective study and a review of the literature

Background: Tick‐borne encephalitis in children appears to be more benign than in adults and shows also a more favourable outcome. Only some authors report of sequelae like paralysis, paresis or seizures and behavioural abnormalities. The aim was to describe the clinical features of tick‐borne encephalitis in children with special attention to sequelae and to review the literature. Methods: Retrospective review of all charts of children with serologically confirmed tick‐borne encephalitis hospitalised in Styria between 1981 and 2005. Results: One hundred sixteen children were diagnosed with tick‐borne encephalitis. Ninety‐two children (79.3%) developed meningitis and 24 (20.7%) meningoencephalitis. Eleven patients with meningoencephalitis showed somnolence, 5 confusion, 5 tremors, 2 facial palsy, 1 ataxia, 1 epileptic seizure and 1 hemi paresis. Seven patients had to be admitted to the intensive care unit. Two children (1.7%) developed long time neurological sequelae: one epileptic seizure with requirement of antiepileptic therapy and one left‐sided hemi paresis. One hundred twelve children had been not and 3 incompletely vaccinated against tick‐borne encephalitis. Only one child had been fully vaccinated according to the Austrian vaccination schedule. Conclusion: Our study provides further evidence that tick‐borne encephalitis in children has a substantial morbidity and in single cases severe long‐time neurological sequelae are observed.