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Neurological involvement related to the influenza virus in children: A 5-year single-centre retrospective study
Julie Savagner1, Pauline Trémeaux2, Eloïse Baudou1
1Department of Paediatric Neurology, Toulouse Children's Hospital, 330 Avenue de Grande Bretagne, 31300, Toulouse, France.
Insights
Influenza infection in children frequently causes neurological symptoms like seizures and encephalitis, but most cases resolve quickly. Long-term effects require further study, particularly in those with prior neurological issues.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Neuroscience
Background:
- Influenza virus infection can trigger various neurological conditions in children, including encephalitis, often presenting with seizures.
- The presentation and severity of influenza-related neurological issues can vary based on epidemic strains and a child's medical history.
Purpose of the Study:
- To investigate the incidence and characteristics of neurological manifestations in children hospitalized with influenza.
- To analyze the types of neurological symptoms, patient demographics, and outcomes associated with influenza infection.
Main Methods:
- Retrospective analysis of children with neurological symptoms and confirmed influenza RNA in respiratory samples.
- Inclusion criteria: hospitalization between November 2018 and April 2023 at Toulouse Children's Hospital.
Main Results:
- 10.3% of hospitalized influenza patients (131 children) presented with neurological features.
- Seizures were the most common symptom (73.3%), followed by encephalitis (29%). Most patients (88.5%) showed rapid recovery.
- Influenza A was the predominant strain, and 71.6% of affected children were under 5 years old.
Conclusions:
- Neurological complications are common in pediatric influenza cases but are typically transient.
- Further research is needed to understand long-term neurodevelopmental outcomes, especially in children with pre-existing neurological conditions.
Introduction:
Inflammation related to influenza virus infection can lead to multiple neurological presentations. Encephalitis is one of them, mostly accompanied by seizures, with different profiles depending on the epidemics and previous medical conditions.
Materials And Methods:
All children presenting neurological symptoms and positive for influenza virus RNA detection in a respiratory sample between November 2018 and April 2023, hospitalized in the Department of Paediatric Neurology of Toulouse Children's Hospital, were retrospectively analysed.
Results:
Among the 1,277 children diagnosed with influenza in our centre, 131 (10.3 %) were hospitalized for neurological features. The year 2020-2021 was marked by zero incidence of positive influenza tests, associated with the COVID-19 pandemic. Among the 131 patients included, 71.6 % were under 5 years old. Most of them (80.9 %) were infected by influenza A virus. The first neurological symptoms were mainly seizures in 73.3 % of patients. Possible or confirmed encephalitis was observed in 29 % of cases, including one acute necrotizing encephalopathy. Few children (6.1 %) presented with acute myositis. Twenty-seven patients (20.6 %) had a personal history of significant previous neurological disorders. Most patients (88.5 %) displayed a rapid favourable outcome, marked by the disappearance of their neurological symptoms within the first 2 days. Anti-epileptic drugs were introduced in 1.5 % of cases, and adapted in 16.8 %, mainly in patients with febrile status epilepticus and an abnormal EEG.
Conclusion:
Neurological features were frequently associated with influenza infection in children; most were transient. Effects on long-term neurodevelopmental outcomes need to be clarified as our follow-up was limited, especially in children with pre-existing neurological conditions.
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