Respiratory syncytial virus-associated seizures in Korean children, 2011-2016.

Korean Journal of Pediatrics Pub Date : 2019-04-01 Epub Date: 2018-10-23 DOI:10.3345/kjp.2018.07066
Teahyen Cha, Young Jin Choi, Jae-Won Oh, Chang-Ryul Kim, Dong Woo Park, In Joon Seol, Jin-Hwa Moon
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引用次数: 17

Abstract

Purpose: Respiratory syncytial virus (RSV) infection can cause various neurological complications. This study aimed to investigate the RSV-associated neurologic manifestations that present with seizures.

Methods: We retrospectively reviewed the medical records of patients aged less than 15 years with laboratory-confirmed RSV infections and seizures between January 2011 and December 2016 in a regional hospital in South Korea.

Results: During this period, 1,193 patients with laboratory-confirmed RSV infection were identified. Of these, 35 (35 of 1,193, 2.93%; boys, 19; girls, 16; mean age: 20.8±16.6 months) presented with seizures. Febrile seizure was the most common diagnosis (27 of 35, 77.1%); simple febrile seizure in 13 patients (13 of 27, 48.1%) and complex febrile seizure in 14 (14 of 27, 51.9%). Afebrile seizures without meningitis or encephalopathy were observed in 5 patients (5 of 35, 14.3%), seizures with meningitis in 2 (2 of 35, 5.7%), and seizure with encephalopathy in 1 (1 of 35, 2.9%) patient. Lower respiratory symptoms were not observed in 8 patients. In a patient with encephalopathy, brain diffusion-weighted magnetic resonance imaging revealed transient changes in white matter, suggesting cytotoxic edema as the mechanism underlying encephalopathy. Most patients recovered with general management, and progression to epilepsy was noted in only 1 patient.

Conclusion: Although febrile seizure is the most common type of seizure associated with RSV infection, the proportion of patients with complex febrile seizure was higher than that of general febrile seizure. Transient cytotoxic edema may be a pathogenic mechanism in RSV-related encephalopathy with seizures.

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2011-2016年韩国儿童呼吸道合胞病毒相关癫痫发作
目的:呼吸道合胞病毒(RSV)感染可引起多种神经系统并发症。本研究旨在探讨rsv相关的神经系统表现,呈现与癫痫发作。方法:我们回顾性分析了2011年1月至2016年12月韩国一家地区医院收治的年龄小于15岁的经实验室确诊的RSV感染和癫痫发作患者的病历。结果:在此期间,鉴定出1193例实验室确诊的呼吸道合胞病毒感染患者。其中35例(1193例中35例,2.93%;男孩,19岁;女孩,16岁;平均年龄:20.8±16.6个月)。热性惊厥是最常见的诊断(35例中27例,77.1%);单纯热性惊厥13例(27例中13例,48.1%),复杂热性惊厥14例(27例中14例,51.9%)。无脑膜炎或脑病的发热性发作5例(35例中5例,14.3%),伴脑膜炎发作2例(35例中2例,5.7%),伴脑病发作1例(35例中1例,2.9%)。8例患者未出现下呼吸道症状。在一例脑病患者中,脑弥散加权磁共振成像显示白质的短暂改变,提示细胞毒性水肿是脑病的潜在机制。大多数患者经全面治疗后恢复,只有1例患者进展为癫痫。结论:虽然热性惊厥是RSV感染最常见的惊厥类型,但复杂热性惊厥所占比例高于普通热性惊厥。短暂的细胞毒性水肿可能是rsv相关脑病伴癫痫发作的致病机制。
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12 weeks
期刊介绍: Korean J Pediatr covers clinical and research works relevant to all aspects of child healthcare. The journal aims to serve pediatricians through the prompt publication of significant advances in any field of pediatrics and to rapidly disseminate recently updated knowledge to the public. Additionally, it will initiate dynamic, international, academic discussions concerning the major topics related to pediatrics. Manuscripts are categorized as review articles, original articles, and case reports. Areas of specific interest include: Growth and development, Neonatology, Pediatric neurology, Pediatric nephrology, Pediatric endocrinology, Pediatric cardiology, Pediatric allergy, Pediatric pulmonology, Pediatric infectious diseases, Pediatric immunology, Pediatric hemato-oncology, Pediatric gastroenterology, Nutrition, Human genetics, Metabolic diseases, Adolescence medicine, General pediatrics.
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