背景:与流感病毒感染相关的炎症可导致多种神经系统表现。脑炎就是其中之一,主要伴有癫痫发作,根据流行病和以前的医疗条件不同。
方法:2018年11月至2023年4月期间,所有在图卢兹儿童医院儿科神经科住院的呼吸道样本中出现神经系统症状且流感病毒RNA检测阳性的儿童,进行了回顾性分析。
结果:在我们中心诊断为流感的1,277名儿童中,131(10.3%)因神经系统特征住院。2020-2021年流感检测阳性为零,与COVID-19大流行有关。在131名患者中,71.6%为5岁以下。其中大多数(80.9%)感染了甲型流感病毒。73.3%的患者以癫痫发作为主。在29%的病例中观察到可能或确诊的脑炎,包括一例急性坏死性脑病.很少有儿童(6.1%)出现急性肌炎。27名患者(20.6%)有明显的神经系统疾病的个人病史。大多数患者(88.5%)表现出快速有利的结果,以他们的神经症状在前2天内消失为标志。1.5%的病例使用抗癫痫药物,并适应16.8%,以发热性癫痫持续状态和脑电图异常为主。
结论:神经系统特征常与儿童流感感染相关;大多数是短暂的。对长期神经发育结果的影响需要澄清,因为我们的随访有限,特别是在有神经系统疾病的儿童中。
BACKGROUND: Inflammation related to influenza virus infection can lead to multiple neurological presentations.
Encephalitis is one of them, mostly accompanied by seizures, with different profiles depending on the epidemics and previous medical conditions.
METHODS: All children presenting neurological symptoms and positive for influenza virus RNA detection in a respiratory sample between November 2018 and April 2023, hospitalized in the Department of Paediatric Neurology of Toulouse Children\'s Hospital, were retrospectively analysed.
RESULTS: Among the 1,277 children diagnosed with influenza in our centre, 131 (10.3 %) were hospitalized for neurological features. The year 2020-2021 was marked by zero incidence of positive influenza tests, associated with the COVID-19 pandemic. Among the 131 patients included, 71.6 % were under 5 years old. Most of them (80.9 %) were infected by influenza A virus. The first neurological symptoms were mainly seizures in 73.3 % of patients. Possible or confirmed
encephalitis was observed in 29 % of cases, including one acute necrotizing encephalopathy. Few children (6.1 %) presented with acute myositis. Twenty-seven patients (20.6 %) had a personal history of significant previous neurological disorders. Most patients (88.5 %) displayed a rapid favourable outcome, marked by the disappearance of their neurological symptoms within the first 2 days. Anti-epileptic drugs were introduced in 1.5 % of cases, and adapted in 16.8 %, mainly in patients with febrile status epilepticus and an abnormal EEG.
CONCLUSIONS: Neurological features were frequently associated with influenza infection in children; most were transient. Effects on long-term neurodevelopmental outcomes need to be clarified as our follow-up was limited, especially in children with pre-existing neurological conditions.