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

The patient was a 7-week-old female baby who visited our hospital due to respiratory difficulty, high fever (38.7ºC), and lethargy. Her 3-year-old elder brother had had a respiratory infection recently. Before admission, the patient was healthy and had no family history of seizure disorders. On the day of admission, she experienced three consecutive generalized tonic-clonic seizures with fever. Consciousness recovery between seizures was uncertain. After the admi nistra tion of intravenous lorazepam and phenobarbital, the sei zures stop ped. A polymerase chain reaction-based virus test using nasopharyn geal swab revealed RSV infection; CSF cytological tests, biochemical tests, and bacterial cultures yielded no abnormalities. Brain MRI with DWI performed at first hospital day revealed high signal intensity (HSI) at the internal capsule and splenium of corpus callosum on DWI and subtle low signals on apparent diffusion coefficient (ADC) imaging at the same area. The HSI on DWI rapidly disappeared by the fourth hospital day, suggesting that the mechanism of encephalo pathy was transient cytotoxic edema (Fig. 2) . The EEG recordings showed sharp discharges from the frontotemporal area. The patient was admitted to the PICU, and gradually recovered over a week. In a follow-up visit at 12 months of age, neurological compli cation was not found and the abnormal discharges on EEG had disappeared.