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[Case of non-convulsive status epilepticus after influenza virus B infection]

Hayato Une1, Taira Uehara, Takahisa Tateishi

  • 1Department of Neurology, Neurological institute, Graduate School of Medical Sciences, Kyushu University.

Rinsho Shinkeigaku = Clinical Neurology
|April 8, 2014
PubMed

Insights

Influenza B virus infection can trigger non-convulsive status epilepticus (NCSE), a type of seizure affecting consciousness. Prompt treatment with anti-epileptic drugs and steroids led to recovery without neurological deficits in this case.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Neuroimmunology

Background:

  • Influenza virus infections can rarely lead to neurological complications.
  • Encephalopathy is a known but uncommon complication of influenza, characterized by altered mental status.
  • Non-convulsive status epilepticus (NCSE) is a prolonged seizure state that may present with subtle or absent motor symptoms, primarily affecting consciousness.

Observation:

  • A 24-year-old female presented with impaired consciousness following influenza B virus infection.
  • Neurological examination revealed mild disturbance of consciousness; laboratory tests showed elevated inflammatory markers (CRP, IL-6, TNF-α) including IL-6 in cerebrospinal fluid.
  • Electroencephalography (EEG) demonstrated continuous generalized spike and wave complexes, indicative of epileptic activity.

Findings:

  • The patient was diagnosed with influenza encephalopathy presenting as NCSE.
  • Treatment with methylprednisolone pulse therapy, prednisolone, phenytoin, and sodium valproate resulted in improved consciousness.
  • EEG showed persistent epileptic discharges requiring the addition of levetiracetam, leading to near-complete resolution of discharges by day 12.

Implications:

  • This case highlights a rare neurological complication of influenza B, specifically NCSE.
  • The findings suggest that influenza encephalopathy can transiently induce NCSE, which is responsive to immunomodulatory and anti-epileptic therapies.
  • Early recognition and aggressive management are crucial for favorable outcomes in patients with influenza-associated NCSE.

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