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 respiratory syncytial virus (RSV) is an important cause of acute respiratory tract infection in young children. The common respiratory manifestations are bronchiolitis, pneumonia, bronchitis, and croup. By the age of 2 years, approximately 90% children are infected by RSV, and approximately 45% of the RSV-related hospital admissions occur in children younger than 6 months. 1, 2) As in other common viral infections, RSV may be associated with neurological manifestations, including seizures, encephalopathy, extraocular movement disorder, and central apnea. [3] [4] [5] [6] [7] [8] Although the pathogenesis of the neurologic complications are not fully understood, the possible contributions of immune-related cytokine responses, less well-proven direct invasion of virus particles, and brain stem-related mechanisms for respiratory control have been recognized. 3, 5, [9] [10] [11] caused by factors other than RSV infections, and those with epilepsy were excluded. In this study, a simple febrile seizure was defined as a seizure occurring during a febrile illness and not caused by an acute disease of the nervous system in children aged between 6 months and 5 years. 18) The seizure should be generalized and short (duration less than 15 minutes) and not recur within 24 hours. Complex febrile seizure was defined as a 1) focal, 2) generalized, and prolonged seizure lasting more than 15 minutes and recurring with 24 hours, or 3) postictal neurological abnormalities, such as Todd's palsy. 18) This study was performed in a regional hospital in Guri, a city located in the metropolitan area around Seoul. All research protocols were ap proved by the Institutional Review Board (IRB) at Hanyang University Guri Hospital (approval number: 2017-12-014). Informed consent was exempted by the IRB.