Respiratory syncytial virus-associated seizures in Korean children, 2011–2016

Cha, Teahyen; Choi, Young Jin; Oh, Jae-Won; Kim, Chang-Ryul; Park, Dong Woo; Seol, In Joon; Moon, Jin-Hwa

Febrile seizure may occur in any condition with acute elevation of body temperature in genetically predisposed children. The peak incidence age is approximately 18 months. 23) Most of the febrile seizures are generalized, with approximately one-third of the patients exhibiting complex febrile seizure and febrile status epilepticus occurring in 5% of the cases. 24) However, the RSV-related febrile seizure have not been well-characterized. The well-known study of Sweetman et al. 7) reported the incidence of neurological complication associated with RSV to be 1.2% (12 of 964 patients). The authors included 1 patient with complex febrile seizure but excluded five patients with simple febrile seizure. In the present study, the incidence of RSV-associated seizures, including febrile seizure, was 2.9%, which is higher than the finding of Sweetman et al. 7) The global features of febrile seizure observed in this study were similar to those of the generally known febrile seizure, such as age and benign nature. However, the incidence of com plex febrile seizure was higher than that of simple febrile seizure. Most of the patients showed multiple seizures in a day, which may be a distinguishing characteristic of RSV-associated febrile seizure. The reason of higher incidence of complex febrile seizure in RSVassociated febrile seizure is unclear. Previous studies reported the increased levels of CSF proinflammatory cytokines such as interleukin (IL)-6, IL-8, monocyte chemoattractant protein-1 and macrophage inflammatory protein-1β in patients with encephalopathy who had RSV infection. Although febrile seizure is not as severe as encephalopathy is, RSV-specific cytokine responses may be related with multiple or prolonged RSV-associated febrile seizures. 11, 25, 26) As RSV is one of the common infections in young children, there should be further studies of the characteristics of febrile seizure in RSV infection.