Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, Ignaz-Harrer-Straße 79, 5020, Salzburg, Austria.
Department of Neurology, Christian Doppler University Hospital, Paracelsus Medical University, Ignaz-Harrer-Straße 79, 5020, Salzburg, Austria.
J Clin Virol. 2020 Jun;127:104340. doi: 10.1016/j.jcv.2020.104340. Epub 2020 Mar 30.
Neurological complications associated with influenza (NCI) are rare events in adults with seasonal influenza. Information about the characteristics of neurological complications and the burden of disease has been limited to case reports, mainly during the pandemic 2009. Influenza-associated encephalopathy/encephalitis (IAE) is one of the most severe and frequently reported NCI, mostly caused by influenza A. Isolated case reports exist about NCI caused by influenza B.
The aim of this single center retrospective study is the better understanding of the frequency and the characteristics of NCI in adults in season 2017-2018, depending on the influenza subtype A or B.
We reviewed 874 adult patients with laboratory confirmed influenza admitted to the Christian Doppler University Hospital Salzburg, Austria from December 2017 until March 2018 looking for NCI.
37 (4 %) of the 874 patients with confirmed influenza had NCI. 4 (11 %) had influenza A and 33 (89 %) had influenza B. IAE was the most frequent complication diagnosed in 24 (65 %) patients, of whom all but one had influenza B and 3 (13 %) had neurological residuals. Moreover 6 (16 %) had isolated epileptic seizures, 2 (5 %) had acute inflammatory demyelinating polyneuropathy (AIDP), and 5 (14 %) were classified as having infection-associated stroke.
We report an incidence of 4 % for NCI and a high frequency of IAE caused by subtype B. Therefore, we recommend considering both influenza A and B as an etiologic factor of encephalopathy and other neurological disease in adults.
成人季节性流感相关的神经系统并发症（NCI）较为罕见。关于神经系统并发症的特征和疾病负担的信息仅限于病例报告，主要是在 2009 年大流行期间。流感相关性脑病/脑炎（IAE）是最严重和常报告的 NCI 之一，主要由甲型流感引起。存在少数关于乙型流感引起的 NCI 的个案报告。
本单中心回顾性研究的目的是更好地了解 2017-2018 年季节成人中 NCI 的频率和特征，取决于流感 A 型或 B 型。
我们回顾了 2017 年 12 月至 2018 年 3 月期间在奥地利克里斯蒂安多普勒大学医院萨尔茨堡因实验室确诊的流感而住院的 874 例成人患者，寻找 NCI。
874 例确诊流感患者中有 37 例（4%）发生了 NCI。4 例（11%）为流感 A，33 例（89%）为流感 B。IAE 是诊断最常见的并发症，共 24 例（65%），其中除 1 例外均为乙型流感，3 例（13%）有神经后遗症。此外，6 例（16%）有孤立性癫痫发作，2 例（5%）有急性炎症性脱髓鞘性多发性神经病（AIDP），5 例（14%）被归类为感染相关脑卒中。
我们报告 NCI 的发生率为 4%，B 型引起的 IAE 频率较高。因此，我们建议将 A 型和 B 型流感均视为成人脑病和其他神经系统疾病的病因。
