Delirious behavior in children with influenza: its clinical features and EEG findings

Akihisa Okumura1, Takashi Nakano, Yukiko Fukumoto

  • 1Department of Pediatrics, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi 466-8550, Japan. okumura@med.nagoya-u.ac.jp

Insights

Electroencephalogram (EEG) findings in children with influenza-associated delirium show mild, transient abnormalities. These EEG results may help distinguish delirium from more severe influenza-associated encephalitis or encephalopathy.

Area of Science:

  • Pediatric Neurology
  • Infectious Diseases

Background:

  • Influenza can cause neurological complications in children, including delirium.
  • Differentiating influenza-associated delirium from encephalitis/encephalopathy is crucial for appropriate management.

Purpose of the Study:

  • To investigate the clinical characteristics and electroencephalogram (EEG) findings in children with influenza-associated delirium.
  • To determine if EEG can help differentiate delirium from influenza-associated encephalitis/encephalopathy.

Main Methods:

  • A study of 15 children with delirious behavior associated with influenza.
  • Clinical courses were reviewed using medical records.
  • Electroencephalogram (EEG) was performed during delirious episodes when feasible.

Main Results:

  • 13 out of 15 children had a high fever (≥39.0°C) during delirium.
  • 10 children showed subtle consciousness reduction, and 5 experienced seizures.
  • EEG revealed mild abnormalities in 13 children, including background slowing and slow wave activity, which normalized post-delirium.

Conclusions:

  • Electroencephalogram (EEG) findings in influenza-associated delirium are typically transient and mild.
  • EEG may serve as a valuable tool in the diagnostic evaluation of children with influenza-associated delirium, aiding in its differentiation from encephalitis/encephalopathy.

Related Concept Videos

Encephalitis l: Introduction01:19

Encephalitis l: Introduction

Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...
Encephalitis ll: Pathophysiology01:26

Encephalitis ll: Pathophysiology

Encephalitis is inflammation of the brain parenchyma caused by direct viral invasion or immune-mediated mechanisms triggered by infections or tumors. Both processes lead to neuronal injury, disrupted neurotransmission, and diverse neurological symptoms, often with overlapping clinical and pathological features.Autoimmune EncephalitisIn autoimmune encephalitis, antibodies target neuronal antigens on cell surfaces, synapses, or within neurons. A key example is anti-NMDAR encephalitis, which can...
Viral Meningitis01:18

Viral Meningitis

Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
Influenza01:27

Influenza

Influenza is an acute, highly communicable viral disease that affects the respiratory tract and is responsible for seasonal epidemics worldwide. Influenza A is the most prevalent type associated with widespread outbreaks and is subtyped based on two surface glycoproteins: hemagglutinin (H) and neuraminidase (N), as in H1N1. These glycoproteins are essential for viral infectivity, transmission, and immune recognition. Transmission occurs primarily through respiratory droplets and contaminated...