ABSTRACT
Background/aim: Mild encephalitis/encephalopathy with a reversible splenial lesion (MERS) is a rare clinicoradiological syndrome that typically presents with central nervous system symptoms such as loss of consciousness, seizure, headache, and ophthalmoparesis. Materials and methods: Here, we highlight the characteristics of this syndrome together with the clinical and MRI findings of 6 pediatric patients with MERS. Results: Between January 2017 and October 2020, 6 patients with MERS (3 boys and 3 girls) presented to our center. The mean age was 122 ± 54.6 (min-max: 44-180) months. None of the patients had a chronic disease. In our study, infectious agents were detected in 4 patients (66.6%), while noninfectious causes (one seizure and the other hyponatremia) were detected in two patients. All of our cases were discharged without any sequelae after an average of 12.1 ± 7 (min–max: 4–20) days of hospitalization. In 1 patient (case 6), control MRI could not be performed, and the radiological recovery of our other patients was shown to be between 14 days and 2 months. Conclusion: MERS is an acute encephalopathy with good prognosis and should be considered by neurologists in differential diagnosis due to its variable clinical presentation and specific MRI findings.
ABSTRACT
Introduction: Adolescence is a transitional life-stage accompanied by large biopsychosocial changes and greater psychophysiological vulnerability. Global events like the COVID-19 pandemic may increase vulnerability to depression and anxiety in this population. Poor sleep is often associated with depression, and both sleep and mood have been shown to be strongly impacted by the COVID-19 pandemic, with most studies focusing on adults. The current study investigates psychological distress in young adolescents during the pandemic, and specifically, whether poor sleep before the pandemic predicts psychological distress. Methods: Self-report data were analyzed from 3099 adolescents (9-10 years at baseline) in the population-based, demographically diverse, Adolescent Brain Cognitive Development (ABCD) study across three pre-pandemic annual visits and 3 monthly time points during the COVID-19 pandemic (ages 11-13 years). At each assessment, children and their guardians completed questionnaires including those about sleep, environment, and psychological wellbeing. Gradient Boosted Tree machine learning algorithms were used to identify the strongest predictors of pandemic-related psychological distress in individuals. We trained models using pre-pandemic sleep measures along with demographics, economic, and social measures during the pandemic. We evaluated the performance of the models using area under curve (AUC) metrics and interpreted the models by using the recently proposed SHapley Additive exPlanations methodology. Results: Pandemic-related perceived stress, fear and sadness were accurately detected with our classifiers (AUC = 0.83 for perceived stress, AUC = 0.73 for fear, AUC = 0.79 for sadness). Across all models, shorter sleep duration, prolonged sleep onset latency, and longer time between waking and getting out of bed predicted greater distress. Moreover, female sex, and pandemic-related factors, including greater family conflict, fewer economic resources, and more screen time contributed to prediction performance in all three models. Conclusion: Findings highlight the importance of addressing sleep problems and ensuring sufficient sleep duration in children to protect against the psychological impact of major life events, including the COVID-19 pandemic. Considering the long-lasting effects of sleep, it would be crucial to improve sleep health by targeted prevention, intervention and increased awareness among adolescents.
ABSTRACT
Introduction: The novel COVID-19 disease rapidly escalated into a global pandemic affecting people around the world. While communities imposed mitigation measures to stop the spread of the disease, the mass (home) confinement in addition to the uncertainty of the pandemic led to drastic changes in all aspects of life, including sleep. Sleep health is strongly linked with mental and overall health and could play a protective role against the development of mental distress during the pandemic. Here, we investigated sleep health in a global multicultural sample of adults during the COVID-19 pandemic. Methods: We surveyed 6,882 adults (18-94 years) across 59 countries about their sleep health (RU-SATED scale), sleep behaviors, demographics, pandemic-related factors, and mood between late April and early May 2020. A hierarchical stepwise multiple linear regression was performed to investigate correlates of sleep health. Results: Compared with pre-pandemic times, more than one third of the sample reported an increase in sleep disturbances, and more than half of the sample shifted their sleep schedule towards later bedand wake-up times. Better sleep health was associated with being partnered, older age and living in a higher-income country (p<.001). Poorer sleep health was associated with a stricter level of quarantine, and other pandemic-related factors including being laid off from job, financial strain, or difficulties with transitioning to working from home (R2=.116, p<.001). Domestic conflict emerged as the strongest correlate of poorer sleep health in the regression model. Greater depression and anxiety symptoms were associated with a poorer sleep health (p<.001). In a global comparison, Latin Americans reported the lowest sleep health scores. Conclusion: Our findings highlight how sleep behavior has changed during the international quarantine- and isolation measurements and show the association between pandemic-related factors and poor sleep health, which, in turn, is closely linked with poorer mental health. These results emphasize the importance of maintaining good sleep health during the pandemic, since poorer sleep health may trigger or exacerbate mental disorders. Maintenance of good sleep health should be incorporated into public health messages aimed at helping people maintain optimal mental and physical health during major stressful life events like the COVID-19 pandemic.