Department of Pediatric Neurology, Dr. Sami Ulus Children's Health and Diseases Training and Research Hospital, Ankara, Turkey.
Pediatr Neurol. 2011 Aug;45(2):72-6. doi: 10.1016/j.pediatrneurol.2011.02.010.
The neurologic manifestations and prognoses of a novel influenza A (H1N1) virus infection in previously healthy children were evaluated. Nose and throat swabs were retrieved from all patients who met the criteria of influenza-like illness. A real time reverse-transcriptase polymerase chain reaction assay was used to confirm the novel influenza A (H1N1) virus. This viral infection was evident in 240 children between October 10 and December 22, 2009. Neurologic findings were evident in 17 (7.08%) patients, aged between 4 months and 8 years. Nine were boys. Five patients manifested simple febrile seizures, seven manifested complex febrile seizures or additional afebrile seizures, and three manifested encephalopathy. Febrile status epilepticus and flaccid paralysis were diagnosed in one patient each. All were treated with oseltamivir. Fifteen of 17 patients demonstrated complete recovery. One undergoing follow-up with a diagnosis of Guillain-Barré syndrome manifested sequelae. One patient died because of septic shock and disseminated intravascular coagulation. We suggest that neurologic manifestations occur quite often in children aged less than 5 years with novel influenza A (H1N1) virus infection. Most infections were benign, although a severe course is possible, and sequelae may be encountered.
评估了新型甲型 H1N1 流感病毒感染对既往健康儿童的神经表现和预后的影响。对符合流感样疾病标准的所有患者均采集鼻拭子和咽拭子。采用实时逆转录聚合酶链反应检测来确认新型甲型 H1N1 流感病毒。2009 年 10 月 10 日至 12 月 22 日，共发现 240 名患有该病毒感染的儿童。17 名（7.08%）年龄在 4 个月至 8 岁的患儿出现了神经系统表现。其中 9 名是男孩。5 名患儿表现为单纯性热性惊厥，7 名表现为复杂性热性惊厥或伴有无热惊厥，3 名表现为脑病。1 名患儿诊断为热性惊厥持续状态，1 名患儿诊断为弛缓性瘫痪。所有患儿均接受奥司他韦治疗。17 名患儿中，15 名患儿完全恢复，1 名正在接受吉兰-巴雷综合征的随访，留有后遗症，1 名患儿因感染性休克和弥散性血管内凝血死亡。我们建议，新型甲型 H1N1 流感病毒感染在 5 岁以下儿童中常引起神经系统表现，大多数感染为良性，但也可能出现严重病程，且可能留有后遗症。
