Title
Neurological complications of influenza
Lead Clinician
Dr Rachel Kneen
Consultant Paediatric Neurologist
Roald Dahl EEG Department
Littlewood's Neurosciences Unit
Alder Hey Children's NHS Foundation Trust Liverpool
L12 2AP
Tel :
Additional investigators:
Dr Benedict Michael - NIHR Doctoral Research Fellow, University of Liverpool Dr Ian Hart - Consultant Virologist, Liverpool Royal Hospital
Dr Enitan Carroll - Senior Lecturer in Paediatric Infectious
Diseases, University of Liverpool
Prof Tom Solomon- Chair of Neurosciences, University of Liverpool
Case Definition
Children with an acute neurological illness with recent proven influenza A (including H1N1) or B infection, where recent infection is defined as within 1 month of neurological presentation. This includes cases of encephalopathy, encephalitis, encephalomyelitis, myelitis, radiculitis, Guillain-Barre/Fisher syndrome, peripheral neuropathy, myositis or any other acute neurological disorder. Fatal cases should be included if acute neurological abnormalities are identified at post mortem.
Definitions:
Encephalopathy: an alteration in consciousness including behavioural changes with no evidence of inflammation in the CNS.
Encephalitis: an encephalopathy with or without seizures or focal neurological signs, with evidence of inflammation in the CNS [cerebrospinal fluid (CSF) white cell count >4/ml, or magnetic resonance imaging (MRI) consistent with inflammation].
Myelitis: sensory and/or motor symptoms and signs attributable to a spinal cord lesion, with evidence of inflammation in the CNS (as above).
Radiculitis: sensory and/or motor symptoms and signs attributable to inflammation of the spinal nerve roots.
Guillain-Barre/Fisher syndrome: see definition on BPSU website
Peripheral neuropathy: sensory and/or motor symptoms and signs attributable to peripheral nerve pathology.
Myositis: symptoms and signs attributable to muscle inflammation including elevation of peripheral muscle enzymes.
Microbiological definition: Cases should have proven influenza infection with evidence of positive PCR for influenza RNA (types A or B) from the CSF, serum, throat or nasal swabs, respiratory secretions or sputum and/or elevation of IgG titres in the serum or CSF and/or the presence of IgM titres in the serum or CSF.
Age range for cases: 0-18 years
Inclusion Criteria
See above
Exclusion Criteria
Children & young people with an acute neurological disorder who have no evidence of influenza infection