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Cited by 93Infectious Encephalopathies and EncephalitisInfluenza Virus Research StudiesVirology and Viral Diseases

Neurological complications of pandemic influenza A H1N1 2009 infection: European case series and review

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Surana, Pinki, Tang, Shan, McDougall, Marilyn, Tong, Cheuk Yan William, Menson, Esse, Lim, Ming·2011·European Journal of Pediatrics
DOI 10.1007/s00431-010-1392-3PMC PMC7086688
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Abstract

Neurological manifestations and outcomes of children with the 2009 H1N1 virus infection have been reported in three American series and from smaller cohorts and case reports worldwide. Of the 83 children admitted between April 2009 and March 2010 with H1N1 virus infection to a tertiary children's hospital in a European setting, five children aged between 2 and 10 years had neurological symptoms. Four patients had seizures and encephalopathy at presentation. One patient presented with ataxia; one developed neuropsychiatric manifestations, and two developed movement disorders during the disease course. Early neuroimaging showed evidence of acute necrotising encephalopathy (ANE) in one case and non-specific white matter changes in another. Initial neuroimaging was normal for the other three, but interval MRI showed increased signal in bilateral periventricular distribution in one and significant cerebral volume loss in the other. Clinical outcomes varied: two recovered fully while three had residual seizures and/or significant cognitive deficits. Conclusion An analysis of our patients along with all reported cases reveal that seizures and encephalopathy were common neurological presentations associated with pandemic 2009 H1N1 influenza virus infection in children requiring hospital admission. Neuroimaging suggestive of ANE, basal ganglia involvement and volume loss appears to be associated with worse neurological outcome.

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  • Neuropsychiatric manifestations have been reported following infection with neurotropic influenza A variants and after non-neurotropic H1N1 virus infection, especially in children.

    “Intriguingly, neuropsychiatric manifestations were not only reported following infection with neurotropic influenza A variants but also after non-neurotropic H1N1 virus infection, especially in children [121].”

    From Revisiting the Pathogenesis of X-Linked Adrenoleukodystrophy (2025) · cites this paper as [121]

    The Discussion (Neurological presentation and CSF investigation; page unavailable) reports a neuropsychiatric manifestation in a child with 2009 H1N1 infection. The Introduction (page unavailable) describes neurological conditions associated with neurovirulent influenza strains, but our copy does not classify the 2009 H1N1 strain as non-neurotropic or specifically report neuropsychiatric manifestations following the neurotropic variants. (LLM, conf=0.82)

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Cited by

Sorted by citations

Authors
Surana, P., Tang, S., McDougall, M., Tong, C. Y. W., Menson, E., & Lim, M.
Affiliations
  • St Thomas' Hospital (GB)
  • Evelina London Children's Healthcare (GB)
Corresponding author
Lim, Ming
ORCID
Venue
European Journal of Pediatrics
Publisher
Springer Science and Business Media LLC
Published
2011-01-14
Volume
170
Issue
8
Pages
1007-1015
ISSN
  • 0340-6199 (ISSN-L)
  • 1432-1076
DOI
10.1007/s00431-010-1392-3
PMC
PMC7086688
OpenAlex
W2022753212
Cited by
93
References
1
Citations by year
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FWCI
5.42
Type
journal article
Language
en
Open access
Licence
Locations
  • European Journal of Pediatrics (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Research Portal (King's College London) (submittedVersion)
Topics
  • Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
  • Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
  • Health Sciences › Medicine › Epidemiology › Virology and Viral Diseases
Keywords
2009 H1N1 pandemic, H1N1 influenza, neurological complications, pediatric influenza, seizures, encephalopathy, ataxia, neuropsychiatric symptoms, movement disorders, basal ganglia involvement, neuroimaging, neurological outcome, cognitive impairment
MeSH terms
Adolescent, Child, Child, Preschool, Female, Humans, Infant, Influenza, Human, Male, Nervous System Diseases, Seizures, Encephalitis, Viral, Influenza A Virus, H1N1 Subtype

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