SEIZURES AND OTHER NEUROLOGICAL COMPLICATIONS ASSOCIATED WITH RESPIRATORY SYNCYTIAL VIRUS BRONCHIOLITIS
Abstract number :
1.400
Submission category :
Year :
2003
Submission ID :
3748
Source :
www.aesnet.org
Presentation date :
12/6/2003 12:00:00 AM
Published date :
Dec 1, 2003, 06:00 AM
Authors :
Laura L. Sweetman, Yu-tze Ng, Ian J. Butler, John B. Bodensteiner Child Neurology, Barrow Neurological Institute, St Joseph[apos]s Hospital and Medical Center, Phoenix, AZ; Child Neurology, University of Texas-Houston Medical School, Houston, TX
To characterize further seizures and other neurological complications associated with respiratory syncytial virus (RSV) bronchiolitis.
The coded diagnoses of all RSV bronchiolitis patients less than 14 years of age admitted to our institution over the previous five years were reviewed. Those patients with concommitant diagnoses consistent with neurological disease underwent detailed chart review.
There were 964 patients (age 0 to 13 years) with a diagnosis of RSV bronchiolitis. Thirty-six of these patients had concurrent neurological diagnoses. Eleven patients were excluded because their neurological disorder was pre-existent. A further six patients had probable simple febrile seizures and seven patients had a history of seizure disorder and presented with breakthrough seizures in association with RSV infection. These 13 patients were also excluded from our study. Twelve RSV-positive patients (on nasopharyngeal aspirate immunoflourescence or cultures) had definite neurological complications without another recognized cause. The average age of these patients was 7.9 months (range 1 to 19 months) of whom six were males. Seven of these patients had seizures (predominantly generalized tonic-clonic and one with status epilepticus), three had generalized encephalopathy (marked hypotonia and decreased responsiveness) of whom two also developed esotropia and two patients developed isolated esotropia.
We found an incidence of neurological complications of 1.2% (0.7% seizures) in a total of 964 patients with RSV bronchiolitis. This percentage does not include presumed simple febrile seizures or exacerbations of pre-existing seizure disorder (further 1.3%). These results are consistent with the findings of our previous study at another institution (1,2). Neurological complications, predominantly encephalopathy, occur with RSV bronchiolitis and physicians and other caregivers should be aware of this entity.
1. Ng YT, Cox C, Atkins J, Butler IJ. Encephalopathy associated with respiratory syncytial virus bronchiolitis. [italic]J Child Neurol [/italic]2001;16:105-8.
2. Ng YT, Butler IJ. Respiratory Syncytial Virus. [italic]N Engl J Med [/italic]2001;345:1132[table1]
[Supported by: Nil]