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Influenza-related neurological disorders more common in children
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More children than adults experienced neurological manifestations of influenza, researchers reported in Clinical Infectious Diseases.
“Neurological manifestations are an important complication of influenza infection,” the researchers wrote. “A wide variety of acute neurological presentations are reported, of which febrile seizures and encephalopathy are the most common and approximately three-quarters of cases occur in children.”
A 2-year surveillance study conducted at British adult and pediatric neurological surveillance units since February 2011 identified 25 cases of influenza-related neurological disorders. Cases were included in the study if they met clinical case definitions 1 month after a confirmed influenza infection.
Of the 25 cases, 21 (84%) were children and four (16%) were adults. Of the pediatric cases, six (29%) had pre-existing neurological disorders. PCR analyses of respiratory samples identified influenza A in 21 cases (81%) and influenza B in four cases (15%).
Twelve children had encephalopathy, including one patient with a movement disorder; eight children had encephalitis; and meningoencephalitis occurred in one child. Two of the adult cases had encephalopathy with movement disorder; one adult had encephalitis; and one had Guillain-Barré syndrome. Seven patients, including one child, had specific acute encephalopathy syndromes; four patients had acute necrotizing encephalopathy; one patient had acute infantile encephalopathy; one patient had hemorrhagic shock and encephalopathy; and one had acute hemorrhagic leukoencephalopathy.
Twenty cases (80%) required intensive care. Of these, 17 (68%) had poor outcome and four (16%) died, representing “a more severe spectrum of neurological manifestations,” according to the researchers.
“None of the cases had been vaccinated despite indications and therefore their deaths or poor outcome may have been prevented,” they wrote. “A broad spectrum of acute encephalopathy syndromes was identified, frequently associated with poor outcomes. This data is used to propose a new classification of influenza-related neurological manifestations.”
Disclosure: See the study for a full list of financial disclosures.
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