Seizures Seen in Children with H1N1 Flu
Jane Siegel, MD, of the University of Texas Southwestern Medical Center in Dallas, and colleagues report in the July 24 issue of Morbidity and Mortality Weekly Report that children with flu-like symptoms and unexplained seizures may have H1N1 flu.
Until now seizures and neurologic problems have not been connected to the new pandemic strain. The Dallas County health department reports 4 cases of children with confirmed H1N1 infection who presented with neurologic changes since April of this year. Three of the children had encephalopathy. Two of the children with H1N1 flu had seizures.
The neurological complications associated with previous influenza viruses include seizures, encephalitis, encephalopathy, and Reye syndrome. This report makes it important to keep H1N1 flu in mind when a child is seen with flu-like symptoms and unexplained seizures or mental status changes. Dr Siegel and colleagues suggest immediately beginning antiviral treatment and sending specimens for viral testing for these children.
The 4 cases of H1N1 flu with neurologic symptoms seen in the Dallas area were all boys. The area had 405 confirmed cases of H1N1 flu. The four boys ranged in age from 7 to 17. All have recovered fully after being treated in the hospital with a 5 day course of Tamiflu.
In the 4 cases, the onset of the neurological symptoms occurred from 1-4 days after the development of respiratory disease. The symptoms of H1N1 flu virus in people are similar to the symptoms of seasonal flu and include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue.
Evans A, et al "Neurologic complications associated with novel influenza A (H1N1) virus infection in children -- Dallas, Texas, May 2009" MMWR 2009; 58: 773-778.
NIH (for more information on encephalopathy)