Department of Neurodiagnostics University of Kentucky HealthCare Albert B. Chandler Hospital, Lexington, Kentucky.
Neurodiagn J. 2020 Mar;60(1):41-49. doi: 10.1080/21646821.2020.1725864.
A severe and unusual complication found in children with influenza is an acute necrotizing encephalopathy. A 20-month-old female with no significant past medical history was admitted to our facility, presenting with a 4-day history of worsening fever, upper respiratory symptoms, new-onset altered mental status and episodes of extensor posturing. The initial concern was a dystonic reaction secondary to promethazine following a recent diagnosis of influenza A virus. A head computed tomography scan indicated concern for widespread edema, and the video EEG revealed focal slowing in the frontocentral regions with no epileptiform activity during episodes of extensor posturing. The first magnetic resonance imaging results were consistent with acute hemorrhagic encephalitis or severe anoxic brain injury for which there is a broad differential. A second MRI five days later found new areas of restricted diffusion that were consistent with acute necrotizing encephalitis.
在儿童流感中发现一种严重且不常见的并发症是急性坏死性脑病。一名 20 个月大的女性，无明显既往病史，因发热恶化、上呼吸道症状、新出现的意识状态改变和伸展性姿势发作 4 天而入院。最初的担忧是在最近诊断出甲型流感病毒后，异丙嗪引起的张力障碍反应。头部计算机断层扫描显示广泛水肿，视频脑电图显示在伸展性姿势发作期间，额中央区域出现局灶性减慢，但无癫痫样活动。第一次磁共振成像结果与急性出血性脑炎或严重缺氧性脑损伤一致，鉴别诊断广泛。五天后的第二次 MRI 发现新的弥散受限区域，符合急性坏死性脑炎。
