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Pediatric neurological complications associated with the A(H1N1)pdm09 influenza infection.
[locked-in syndrome]
Influenza-related
neurological
complications
(
INC
)
have
been
reported
during
seasonal
flu
in
children
.
To
investigate
the
types
,
outcomes
and
incidence
of
INC
occurring
during
the
2009
A
(
H
1
N
1
)
pandemic
,
a
retrospective
analyze
was
conducted
in
the
single
French
pediatric
hospital
of
Lyon
from
October
2009
to
February
2010
.
All
children
presenting
with
fever
,
influenza-like
illness
,
respiratory
distress
or
neurological
symptoms
were
tested
for
influenza
A
(
H
1
N
1
)
pdm
09
infection
from
respiratory
specimens
using
real
time
RT-PCR
.
INC
occurred
in
14
A
(
H
1
N
1
)
pdm
09
positive
children
(
7
.
7
%
of
A
(
H
1
N
1
)
pdm
09
positive
children
admitted
to
hospital
)
with
a
median
age
of
5
.
1
years
.
Admission
to
the
intensive
care
unit
(
ICU
)
was
required
for
nine
children
(
64
.
3
%
)
.
Half
of
the
children
with
INC
had
comorbidity
and
three
had
coinfection
,
both
characteristics
mainly
found
in
children
requiring
the
ICU
.
All
children
received
oral
oseltamivir
treatment
.
Febrile
seizures
were
observed
in
eight
children
,
half
of
them
having
a
chronic
comorbidity
(
2
epilepsy
,
1
nonketotic
hyperglycinemia
,
1
anoxic
encephalopathy
)
.
Other
INC
,
less
commonly
reported
,
included
2
cases
of
encephalitis
,
1
encephalopathy
,
1
basilar
artery
thrombosis
,
1
myasthenic
crisis
and
1
coma
.
Eleven
of
the
14
children
(
78
.
6
%
)
recovered
,
one
had
a
minor
disability
,
one
child
developed
a
locked-
in
syndrome
and
one
died
from
complications
of
an
acute
necrotizing
encephalopathy
.
INC
can
be
observed
even
in
children
with
no
underlying
disorder
.
It
may
lead
to
dramatic
issue
in
a
significant
number
of
cases
.
Diseases
Validation
Diseases presenting
"fever"
symptom
22q11.2 deletion syndrome
acute rheumatic fever
alexander disease
allergic bronchopulmonary aspergillosis
canavan disease
carcinoma of the gallbladder
child syndrome
congenital toxoplasmosis
cushing syndrome
cystinuria
dracunculiasis
erdheim-chester disease
esophageal adenocarcinoma
esophageal carcinoma
familial mediterranean fever
focal myositis
hodgkin lymphoma, classical
lamellar ichthyosis
legionellosis
locked-in syndrome
malignant atrophic papulosis
neonatal adrenoleukodystrophy
neuralgic amyotrophy
oculocutaneous albinism
papillon-lefèvre syndrome
pyomyositis
pyruvate dehydrogenase deficiency
scrub typhus
severe combined immunodeficiency
sneddon syndrome
systemic capillary leak syndrome
triple a syndrome
typhoid
waldenström macroglobulinemia
wolf-hirschhorn syndrome
This symptom has already been validated