Clinical and Experimental Pediatrics

대한소아청소년과학회 (The Korean Pediatric Society)
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Respiratory syncytial virus-associated seizures in Korean children, 2011-2016

  • Cha, Teahyen (Department of Pediatrics, Hanyang University College of Medicine) ;
  • Choi, Young Jin (Department of Pediatrics, Hanyang University College of Medicine) ;
  • Oh, Jae-Won (Department of Pediatrics, Hanyang University College of Medicine) ;
  • Kim, Chang-Ryul (Department of Pediatrics, Hanyang University College of Medicine) ;
  • Park, Dong Woo (Department of Radiology, Hanyang University Guri Hospital, Hanyang University College of Medicine) ;
  • Seol, In Joon (Department of Pediatrics, Hanyang University College of Medicine) ;
  • Moon, Jin-Hwa (Department of Pediatrics, Hanyang University College of Medicine)
  • 투고 : 2018.09.11
  • 심사 : 2018.10.22
  • 발행 : 2019.04.15
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초록

Purpose: Respiratory syncytial virus (RSV) infection can cause various neurological complications. This study aimed to investigate the RSV-associated neurologic manifestations that present with seizures. Methods: We retrospectively reviewed the medical records of patients aged less than 15 years with laboratory-confirmed RSV infections and seizures between January 2011 and December 2016 in a regional hospital in South Korea. Results: During this period, 1,193 patients with laboratory-confirmed RSV infection were identified. Of these, 35 (35 of 1,193, 2.93%; boys, 19; girls, 16; mean age: $20.8{\pm}16.6months$) presented with seizure. Febrile seizure was the most common diagnosis (27 of 35, 77.1%); simple febrile seizures in 13 patients (13 of 27, 48.1%) and complex febrile seizures in 14 (14 of 27, 51.9%). Afebrile seizures without meningitis or encephalopathy were observed in 5 patients (5 of 35, 14.3%), seizures with meningitis in 2 (2 of 35, 5.7%), and seizure with encephalopathy in 1 (1 of 35, 2.9%) patient. Lower respiratory symptoms were not observed in 8 patients. In a patient with encephalopathy, brain diffusion-weighted magnetic resonance imaging revealed transient changes in white matter, suggesting cytotoxic edema as the mechanism underlying encephalopathy. Most patients recovered with general management, and progression to epilepsy was noted in only 1 patient. Conclusion: Although febrile seizures are the most common type of seizure associated with RSV infection, the proportion of patients with complex febrile seizures was higher than that of those with general febrile seizures. Transient cytotoxic edema may be a pathogenic mechanism in RSV-related encephalopathy with seizures.

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참고문헌

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피인용 문헌

  1. Case Report: Benign Infantile Seizures Temporally Associated With COVID-19 vol.8, 2020, https://doi.org/10.3389/fped.2020.00507
  2. Antibody development for preventing the human respiratory syncytial virus pathology vol.26, pp.1, 2019, https://doi.org/10.1186/s10020-020-00162-6
  3. Lung pathology due to hRSV infection impairs blood–brain barrier permeability enabling astrocyte infection and a long-lasting inflammation in the CNS vol.91, 2019, https://doi.org/10.1016/j.bbi.2020.09.021
  4. Prevalence, Risk Factors, and Outcomes of Influenza-Associated Neurologic Complications in Children vol.239, 2019, https://doi.org/10.1016/j.jpeds.2021.06.075