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Study of Influenza-Associated Encephalitis/Encephalopathy in Children During the 1997 to 2001 Influenza Seasons
Hideto Yoshikawa, MD
Department of Pediatrics, Niigata City General Hospital, Niigata, Japan
Sawako Yamazaki, MD
Department of Pediatrics, Niigata City General Hospital, Niigata, Japan
Toru Watanabe, MD
Department of Pediatrics, Niigata City General Hospital, Niigata, Japan
Tokinari Abe, MD
Department of Pediatrics, Niigata City General Hospital, Niigata, Japan
The 1997 to 2001 influenza A epidemics in Japan were markedly neurovirulent, and many children died of influenza-associated encephalitis/encephalopathy We studied 20 patients with influenza-associated encephalitis/encephalopathy during the last four influenza seasons. No patients had been previously inoculated with influenza vaccine. Antipyretics were used in 16 patients before the onset of encephalopathy. Although all patients were treated intensively, 5 patients died and 8 had neurologic sequelae. Patients with coagulopathy, hepatic dysfunction, and computed tomographic abnormalities had a poor prognosis. The plasma concentrations of inflammatory cytokines were variable. The neuroradiologic findings could be divided into four categories. These findings indicated that the pathogenesis of the brain damage induced by influenza infection was variable. Further investigation is necessary to determine whether insufficient influenza vaccination or the use of antipyretics is one of the reasons for these epidemics of encephalopathy in Japanese children. (J Child Neurol 2001;16:885-890).
Journal of Child Neurology, Vol. 16, No. 12,
885-890 (2001)
DOI: 10.1177/088307380101601204

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