Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0036572 (seizures)
 80,221 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infection with influenza viruses produces a spectrum of clinical responses, ranging from upper respiratory illness to central nervous system (CNS) involvement. Recently, the number of reports of influenza-associated encephalopathy in Japan has increased. During the winters of 1997-1998 and 1998-1999, when epidemics of type A influenza (H3N2) occurred, many pediatricians reported cases of influenza-associated encephalitis or encephalopathy in children. The prominent indicators of influenza-associated encephalopathy are the abrupt onset of seizures and coma within a few days of developing a high-grade fever. These patients often develop multi-organ failure and have high morbidity and mortality. The pathogenesis of influenza-associated encephalopathy remains unclear. Because not all patients with influenza develop encephalopathy, infection with the influenza vieus is necessary, but not sufficient, for the development of influenza-associated encephalopathy. Viral RNA is rarely detected in the cerebrospinal fluid (CSF), and the presence of viral antigen in the brain has not been proven. Pathological findings, including the lack of detectable viral antigen and inflammatory cells in brain tissues, suggest that direct viral invasion and inflammation are unlikely to be causes of this disease. In influenza-associated encephalopathy, serum and CSF concentrations of several proinflammatory cytokines and cytokine receptors--such as interleukin (IL)-6, IL-1beta, and soluble tumor necrosis factor (TNF) receptor-1 (sTNF-R1)--are elevated and are related to the clinical severity of the disease. Moreover, the damage of vascular endothelial cells has been shown. Using SNPs, molecular analysis of whole genome of the patients are now on going.
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PMID:[Influenza-associated encephalopathy]. 1565 45

In southern Vietnam, a four-year-old boy presented with severe diarrhea, followed by seizures, coma, and death. The cerebrospinal fluid contained 1 white cell per cubic millimeter, normal glucose levels, and increased levels of protein (0.81 g per liter). The diagnosis of avian influenza A (H5N1) was established by isolation of the virus from cerebrospinal fluid, fecal, throat, and serum specimens. The patient's nine-year-old sister had died from a similar syndrome two weeks earlier. In both siblings, the clinical diagnosis was acute encephalitis. Neither patient had respiratory symptoms at presentation. These cases suggest that the spectrum of influenza H5N1 is wider than previously thought.
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PMID:Fatal avian influenza A (H5N1) in a child presenting with diarrhea followed by coma. 1616 64

The clinical characteristics and electroencephalogram (EEG) findings in delirious behavior in children with influenza were studied in order to differentiate it from influenza-associated encephalitis/encephalopathy. Fifteen consecutive children with delirious behavior associated with influenza were investigated. Their clinical courses were investigated using medical records. EEG was obtained during the delirious behavior, when possible. The body temperature during the delirious behavior was 39.0 degrees C or higher in 13 children. A subtle reduction of consciousness was observed in 10 children. Seizures were observed in five children. EEG revealed some mildly abnormal findings in 13 children, including mild slowing of the background activity, insertion of semirhythmic high voltage slow waves, and appearance of relatively high voltage semirhythmic theta waves. The EEG findings normalized after the delirious behavior had disappeared. EEG revealed transient and mild abnormalities in children with delirious behavior but without encephalitis/encephalopathy, and thus might be useful for diagnostic evaluation in such condition.
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PMID:Delirious behavior in children with influenza: its clinical features and EEG findings. 1586 89

Pertussis in adolescents and adults is common, endemic, and epidemic worldwide, and its incidence is reportedly increasing. Although a number of individuals suffer only a mild cough, many others have symptoms typical of pertussis, causing prolonged cough illness, frequent use of health care resources, missed work and a variety of complications. Symptoms experienced by adolescents and adults include sleep disturbance, weight loss, pharyngeal discomfort, influenza-like symptoms, sneezing attacks, hoarseness, sinus pain, headaches and sweating attacks. Even when symptoms are typical of pertussis, the diagnosis is often not considered in adolescents and adults because of a low awareness of the disease in these age groups. Contrary to common perceptions, complications of pertussis, including some that are serious, are not infrequent in adolescents and adults. These include urinary incontinence, rib fracture, pneumothorax, inguinal hernia, aspiration, pneumonia, seizures and otitis media. Despite underreporting, hospitalization of adults and adolescents does occur. Many believe that adolescents and adults are the groups most commonly infected with pertussis and are now the major source of contagion to infants and young children. Because of the considerable health burden, there is a need for improved vaccination strategies to prevent disease in adolescents and adults and to reduce the risk of transmission to vulnerable infants.
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PMID:Health burden of pertussis in adolescents and adults. 1587 23

CD40 ligand (CD40L) is mainly expressed on activated platelets and CD4+T cells, and it can be cleaved from the cell surface, releasing a soluble CD40L (sCD40L). Most sCD40L is derived from activated platelets. A previous paper revealed that the platelet number of patients with influenza virus-associated encephalopathy (IE) was correlated with the outcome. We determined the utility of sCD40L as a predictor for the prognosis of IE. We measured the serum concentration of sCD40L and the platelet number on the day of hospitalization in 34 patients with IE, 16 with influenza virus-associated febrile seizures (IFS), 19 with influenza virus infection without complications (Flu), and 7 with Epstein-Barr virus (EBV) infection. The serum sCD40L concentrations in IE and IFS were significantly lower than those in controls, Flu, and EBV infections. Serum sCD40L concentrations in the IE group were 0.70+/-0.43 ng/ml for deceased patients, 1.73+/-1.36 ng/ml for those with sequelae, and 3.85+/-2.91 ng/ml for those without sequelae. There was no significant difference in platelet number between IE patients with and without sequelae, while the platelet number of deceased patients with IE was significantly lower than in controls, Flu, and IFS. Serum sCD40L concentration on the day of hospitalization was more correlated with the outcome of IE than platelet number. Our findings suggest that the serum sCD40L concentration during acute IE is important for predicting the prognosis at an early stage.
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PMID:Analysis of serum soluble CD40 ligand in patients with influenza virus-associated encephalopathy. 1614 44

The aim of this study was to assess the validity of serum and CSF oxidative status of patients with IE in their initial stage through the d-ROM (Diacron-Reactive Oxygen Metabolites, Italy) test, compared to those with other neurological diseases. The study was conducted on the following four groups: (1) influenza virus-associated encephalopathy (IE, n = 8), including four patients showing neurological sequelae or mortal; (2) influenza virus-associated febrile seizures (IFS, n = 11); (3) febrile convulsion (FC, n = 10): (4) enterovirus-associated encephalopathy (EE, n = 4), including one patient with neurological sequelae. The CSF d-ROM levels in the IE group were significantly higher than those in the IFS and the FC groups but not in the EE group. In addition, general laboratory findings such as leukocytes, platelets, C-reactive protein, aspartate aminotransferase, creatinine, creatinine kinase and LDH, including interleukin-6 (IL-6), were analyzed in each group. The CSF d-ROM levels in the IE group were significantly higher than those in the IFS and FC groups but not in the EE group. As for the serum d-ROM levels and general laboratory findings, with the exception of CSF IL-6 levels in IE, no significant differences were detected compared with the other groups. In patients with IE, the CSF d-ROM levels could be a valid predictive biomarker of the severity, and oxidative stress may be related to the pathogenesis of IE.
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PMID:Diagnostic and predictive value of CSF d-ROM level in influenza virus-associated encephalopathy. 1641 81

To clarify the clinical impact of influenza A on the development of febrile seizures (FS), consecutive FS patients brought to our hospital between October 2003 and September 2004 were prospectively surveyed. Patients infected with influenza A (influenza A patients) and those uninfected with influenza (non-influenza patients) were compared with regard to clinical characteristics of FS. Influenza infection was determined by rapid antigen test and/or serologically. Associations of influenza A with atypical findings of FS, including partial seizures, prolonged seizures, multiple seizures during the same illness, and 30-min or longer prolonged postictal impairment of consciousness (PPIC), were analyzed by multiple logistic regression. A total of 215 patients (47 influenza A and 168 non-influenza patients) were enrolled in the study. Age was significantly higher in the influenza A group (39.85+/-22.16 months vs. 27.51+/-17.14 months, P<0.001). Of 42 patients aged 48 months or older, which corresponded to the 80th percentile for age, 15 (35.7%) were influenza A patients, with a significantly higher incidence of such patients than in the subgroup of patients aged 47 months or younger (32/173, 18.5%) (P=0.015). On multiple logistic regression analysis, influenza A was independently associated with PPIC (odds ratio: 4.44, 95% confidence interval: 1.52-12.95, P=0.006), but not with other atypical findings. The positive association of influenza A with PPIC suggests that influenza may affect state of consciousness at the same time that it induces seizures with fever.
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PMID:Febrile seizures associated with influenza A. 1685 52

The role of viral infection in the etiology of febrile seizures is a relatively neglected field of neurologic research. A National Institutes of Health Consensus Conference (1981) omitted reference to causes of infections and the role of fever in febrile seizures, and emphasized outcome and anticonvulsant treatment. In an earlier review of the world literature (1924-1964), except for roseola infantum, viral infections as a cause of febrile seizures were rarely diagnosed. The present review includes reports of viruses most commonly associated with febrile seizures in the last decade, especially human herpesvirus-6 and influenza. The specificity and neurotropic properties of some viruses in the febrile seizure mechanism, a possible encephalitic or encephalopathic pathology, and the essential role of fever and height of the body temperature as a measure of the febrile seizure threshold are discussed. Cytokine and immune response to infection, and a genetic susceptibility to febrile seizures are additional etiologic factors. Future research should emphasize early detection of causative viruses, the nature of viral neurotropism, and the role of cytokines in fever induction. Trials of antiviral agents and vaccines, with attention to safety concerns, and more effective antipyretics would address the febrile seizure mechanism more specifically than anticonvulsant therapies.
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PMID:Role of viral infections in the etiology of febrile seizures. 1693 54

Intensified official veterinary controls on warehouses supplying Chinese retailers resulted in the seizure of smuggled poultry products. Frozen and vacuum-packed frozen raw duck and chicken carcasses, and anatomic parts (legs) of these species, were collected and processed for laboratory investigations aiming at the detection of avian influenza virus. Real-time reverse transcription-polymerase chain reaction (RRT-PCR) targeting the M gene, performed on the lung and trachea from duck and chicken carcasses, yielded positive results. Virus isolation attempts in specific pathogen free embryonated eggs yielded an H10N7 virus from the duck carcass. The isolate had an intravenous pathogenicity index of 0.0, and phylogenetic analysis revealed a nucleotide homology of 97 and 96% with virus A/duck/Zhejiang/52/2000 (H5N1) for the PB2 and NS genes, respectively. The results of this study indicate that low-pathogenicity avian influenza viruses may be introduced into a country through trade of carcasses regardless of the non-systemic nature of this disease. The export ban applied to countries affected by the H5N1 epidemic may result in increased smuggling of poultry products, which remains one of the means by which influenza viruses can cross-national boundaries. Increased surveillance at borders and at a national level is recommended.
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PMID:Isolation and characterization of an H10N7 avian influenza virus from poultry carcasses smuggled from China into Italy. 1699 Jan 50

A 1-year-old girl with influenza-associated encephalopathy initially exhibited prolonged febrile convulsions and subsequent drowsiness. She became unconsciousness and experienced a cluster of seizures 4 days later. Diffusion-weighted magnetic resonance imaging (DWI) showed high signal intensity in the bilateral frontal white matter. This signal change migrated to the bifrontal cortical areas and the caudate nuclei within 10 days, when T2 elongation appeared over the gray and white matter of frontal lobes. Choreoathetosis and oculogyric crisis were transiently noted at this period. Frontal lobe signs, including the forded mouth opening response, after diminution of these movement disorders. The DWI signal change subsequently resolved and frontal cortical atrophy appeared thereafter. Levels of inflammatory cytokines in the cerebrospinal fluid were normal during the acute phase of clinical course. The biphasic clinical course with initial prolonged seizure, involvement of the frontal lobes, and the progression of signal change on DWI from white to gray matter, meets the characteristics of "status epilepticus-type acute encephalopathy" suggested by Shiomi et al. Although pentobarbital infusion, steroid pulse therapy and mild hypothermia did not show any apparent effects on the clinical course of this patient, further trial of these therapies may be warranted for the treatment of this type of encephalopathy.
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PMID:[Influenza-associated encephalopathy with onset of prolonged convulsion: a case report]. 1709 68


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