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Respiratory Syncytial Virus Infection and Neurologic Abnormalities: Retrospective Cohort Study

Department of Neurology Children's Medical Center of Dallas, UT Southwestern Medical Center, Dallas, TX, nathaniel.kho{at}comcast.net

John F. Kerrigan, MD

Division of Pediatric Neurology Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, Pediatric Intensive Care Unit, Children's Health Center St. Joseph's Hospital and Medical Center, Phoenix, AZ

Timothy Tong, MD

Pediatric Intensive Care Unit, Children's Health Center St. Joseph's Hospital and Medical Center, Phoenix, AZ

Richard Browne, PhD

Sarah M and Charles Seay Center of Neuromuscular Research, Texas Scottish Rite Hospital for Children Dallas, TX

Janet Knilans, BS Ed

Pediatric Intensive Care Unit, Children's Health Center St. Joseph's Hospital and Medical Center, Phoenix, AZ

Respiratory syncytial virus is a common cause of acute respiratory infection in children. Previous reports have associated respiratory syncytial virus infection and acute neurologic symptoms, including apnea and seizures. This study examined the prevalence of acute neurologic symptoms associated with respiratory syncytial virus and non—respiratory syncytial virus respiratory infections in children requiring admission to a pediatric intensive care unit. We screened all admissions over a 4-year period at a single center, identifying children between birth and 2 years of age with bronchiolitis or acute upper respiratory infection. Children with a history of prematurity, preexisting medical conditions, or prior neurologic problems were excluded. Retrospective chart review of 236 admissions was conducted, identifying the etiology of respiratory infection and the presence or absence of acute neurologic signs or symptoms. This study demonstrated a prevalence of acute neurologic signs or symptoms in 36.4% of respiratory syncytial virus—negative patients (n = 115) and 39.1% in the respiratory syncytial virus—positive group (n = 121). Apnea, the most common symptom, was observed in 19.8% of respiratory syncytial virus—positive cases and 16.5% of —negative patients. Seizures were reported in 6.6% of the positive cases and in 12.2% of the negative cohort. These differences showed no statistical significance. Although neurologic signs and symptoms are common in this population of children with acute respiratory infection, there was no significant difference in the prevalence of neurologic problems between respiratory syncytial virus—positive and —negative patients. (J Child Neurol 2004; 19:859-864).

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