BURN ENCEPHALOPATHY IN CHILDREN

Abstract

Numerous reports suggest that burn encephalopathy has an obscure etiology. It has been our experience, however, that the cause is usually readily discovered. Neurological disturbances ranging from hallucination, personality changes, and delirium to seizures and coma were encountered in 20 children among 140 admitted with acute thermal injury to our unit during a two-year period. Encephalopathy was not restricted to children with the most extensive burns. Hypoxia was the principal determinant in nine of the 20 cases, hypovolemia in one, sepsis in four, hvponatremia in four, while cortical vein thrombosis was the cause of focal seizures in one child. In but a single patient was the cause obscure. Encephalopathy associated with hypertension or hypercalcemia was not encountered. Ten children succumbed to their burns. Only one died as a primary result of his central nervous system insult, the rest having been lost because of uncontrolled infections. All survivors of encephalopathic episodes showed virtually complete neurological recovery despite severe and prolonged symptoms in several of the children.