Mild influenza encephalopathy with biphasic seizures and late reduced diffusion

Two Japanese infants with influenza A infection presented with a brief febrile seizure, followed by secondary seizures and disturbance of consciousness on day 5. Magnetic resonance imaging revealed reduced subcortical diffusion around day 5. Both were diagnosed with mild form of acute encephalopathy syndrome characterized by biphasic seizures and late reduced diffusion. It is important for clinicians in Asian countries to recognize and to inform parents that secondary progression may occur even after a brief febrile seizure with influenza.