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The age at diagnosis ranged from 14 months to 11 years. All patients presented with fever and confusion, and the majority also presented with seizures. All patients had lasting neurologic sequelae including seizures, movement disorders, behavioral problems, attention-deficit hyperactivity disorder (ADHD), learning problems, anxiety, and sleep disturbances. This is the largest pediatric case series of Powassan virus encephalitis to date. These cases demonstrate the emergence of Powassan virus as a rare, but severe, cause of encephalitis in children that has long-term neurologic consequences. We recommend increased clinical surveillance and public awareness of this increasingly prevalent tickborne disease.<\/jats:p>","DOI":"10.1177\/08830738251333465","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T02:45:28Z","timestamp":1745808328000},"page":"824-831","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":5,"title":["Powassan Virus Encephalitis in Pediatric Patients"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7117-3377","authenticated-orcid":false,"given":"Celia","family":"Greenlaw","sequence":"first","affiliation":[{"name":"Department of Neurology, Boston Children's Hospital, Fegan 11, 300 Longwood Avenue, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9653-2973","authenticated-orcid":false,"given":"Rebecca","family":"MacRae","sequence":"additional","affiliation":[{"name":"Department of Neurology, Boston Children's Hospital, Fegan 11, 300 Longwood Avenue, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Molly","family":"Wilson-Murphy","sequence":"additional","affiliation":[{"name":"Department of Neurology, Boston Children's Hospital, Fegan 11, 300 Longwood Avenue, Boston, MA 02115, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,27]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/22221751.2022.2155585"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-017-0724-3"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ttbdis.2018.01.002"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.2004.71.3.0700268"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa1183"},{"key":"e_1_3_2_7_2","unstructured":"Centers for Disease Control and Prevention (CDC). 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