Millichap John J, Wainwright Mark S
Division of Neurology, Children's Memorial Hospital, North-western University Medical School, Chicago, Illinois, USA.
J Child Neurol. 2009 Dec;24(12):1499-503. doi: 10.1177/0883073808331362. Epub 2009 Mar 4.
Respiratory syncytial virus is a common cause of infection in children. The authors summarize the clinical and diagnostic features of 9 patients admitted to the pediatric intensive care unit with neurological consultation. Patients were aged 5 weeks to 3 years. Four had seizures, 4 had cardiac arrest, and 1 had hypertonia. Results of brain magnetic resonance imaging in 5 patients was abnormal in 1. Cerebrospinal fluid in 4 patients showed elevated protein in 1. Serum sodium was low in 2 patients and normal in 7. Electroencephalograms in 8 patients were abnormal in 7. Increased risk of neurological complications of respiratory syncytial virus should be considered in any patient with documented infection requiring intensive care. Clinical manifestations may include seizures, encephalopathy, and abnormal neurological examination. The authors' data suggest that the electroencephalogram provides a sensitive method for detection of neurological insult in this group of patients.
呼吸道合胞病毒是儿童感染的常见病因。作者总结了9例因神经科会诊而入住儿科重症监护病房患者的临床和诊断特征。患者年龄为5周龄至3岁。4例出现惊厥,4例发生心脏骤停,1例出现肌张力亢进。5例患者的脑部磁共振成像结果有1例异常。4例患者的脑脊液检查显示有1例蛋白升高。2例患者血清钠水平低,7例正常。8例患者的脑电图检查有7例异常。对于任何确诊感染且需要重症监护的患者,均应考虑呼吸道合胞病毒所致神经并发症风险增加。临床表现可能包括惊厥、脑病和神经系统检查异常。作者的数据表明,脑电图检查为检测该组患者的神经损伤提供了一种敏感方法。