Pediatric Rehabilitation Outcomes in Severe Neuroinvasive Powassan Virus Infection: A Case Series

Objective: This case series describes the presentation, clinical course, and functional outcomes of four pediatric patients with neuroinvasive Powassan virus infection who were admitted to inpatient rehabilitation with severe neurologic impairments. Design/Methods: Retrospective case series. Results: Inpatient rehabilitation treatment resulted in functional improvement across all patients with the most consistent gains noted in cognitive functions, including comprehension and social interaction. Younger age at time of infection was associated with delayed-onset seizure disorder, more severe impairment, and worse long-term outcomes. Older patients demonstrated a movement disorder predominant phenotype and faster return to community-based activities. Conclusion: As cases of pediatric neuroinvasive Powassan virus cases rise, physiatrists in endemic areas should be prepared to recognize associated neurologic patterns and rehabilitation trajectories.