Key result
Steroid pulse therapy provided better clinical improvement over time and increased the possibility of full recovery compared to low dose dexamethasone in children with viral encephalitis.
Why the study?
Encephalitis is a serious, potentially fatal condition, and the comparative effect of steroid pulse therapy versus low-dose steroid on Glasgow Coma Scale improvement, morbidity, and mortality in pediatric viral encephalitis required assessment.
Does high dose steroid pulse therapy improve GCS, morbidity, and mortality in children with viral encephalitis compared to low dose dexamethasone?
RCT (n=100)
Double-blind
randomized
No
Does high dose steroid pulse therapy improve GCS, morbidity, and mortality in children with viral encephalitis compared to low dose dexamethasone?
High dose steroid pulse therapy is effective, increases the possibility of full recovery, and significantly reduces the duration of hospital stay in pediatric patients with viral encephalitis compared to low dose dexamethasone.
Pulse steroid therapy may speed GCS recovery and shorten stays in pediatric viral encephalitis; leaves open need for larger confirmatory trials.
Background: A number of illnesses, including viral infections, bacterial infections, parasitic infestation, toxin, and autoimmune reactions to vaccines, can result in encephalitis, a serious, potentially fatal condition. Objective: The aim of the current study was to assess the effect of steroid pulse therapy versus low dose steroid on improvement of Glasgow Coma Scale (GCS), morbidity, and mortality among children with viral encephalitis. Patients and methods: A randomised controlled, double-blind, clinical trial was carried out for from January 1, 2021 to December 31, 2021, at Assiut University Children Hospital (AUCH). All children treated for viral encephalitis at the Neurology Unit at AUCH during the research period were recruited. Participants were randomized into two groups: Group 1 (n=50) received dexamethasone on dose 0.6mg/kg per day for 5 days, while Group 2 (n=50) received steroid pulse therapy (high dose methylprednisolone on dose 30mg/ kg per day for 5 days) followed by short course of oral prednisolone over 6 weeks. Results: The 2 studied groups showed improvement over time (from baseline to day 1, and day 5), but the degree of improvement was much better in Group 2 (steroid pulse therapy group). Conclusion: Steroid pulse therapy is effective, increases the possibility of full recovery and significantly reduces the duration of hospital stay needed for pediatric patients with viral encephalitis.
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Askar et al. (2023) conducted an RCT in viral encephalitis (n=100). Steroid pulse therapy (high dose methylprednisolone) vs. Low dose dexamethasone (0.6mg/kg per day for 5 days) was evaluated on improvement of Glasgow Coma Scale (GCS), morbidity, and mortality. Steroid pulse therapy provided better clinical improvement over time and increased the possibility of full recovery compared to low dose dexamethasone in children with viral encephalitis.
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