Rinsho Shinkeigaku (Clinical Neurology)

Brief Clinical Note

A case of non-convulsive status epilepticus after influenza virus B infection

Hayato Une, M.D.1), Taira Uehara, M.D., Ph.D.1), Takahisa Tateishi, M.D., Ph.D.1), Hiroshi Shigetou, M.D., Ph.D.1), Yasumasa Oyagi, M.D., Ph.D.1) and Jun-ichi Kira, M.D., Ph.D.1)

1)Department of Neurology, Neurological institute, Graduate School of Medical Sciences, Kyushu University

A 24-year-old woman was referred to our hospital because of impaired consciousness after influenza virus B infection. Neurological examination revealed mild disturbance of consciousness without other neurological abnormalities. Laboratory tests showed elevated serum CRP, IL-6 and TNF-α levels. The level of IL-6 in the cerebrospinal fluid was also slightly elevated. Electroencephalography (EEG) disclosed almost continuous generalized spike and wave complexes and multiple spikes and wave complexes at 1.5 3 Hz. Brain MRI was normal. She was diagnosed as having influenza encephalopathy presenting non-convulsive status epilepticus (NCSE), and commenced methylprednisolone pulse therapy followed by prednisolone with gradual tapering. She was also treated with intravenous phenytoin and oral sodium valproate for NCSE. The next day, her consciousness level had improved. Although she became alert, epileptic discharges on EEG were still observed on the seventh hospital day, and levetiracetam was added. Then, her epileptic discharges almost completely disappeared on the twelfth hospital day. She was discharged without any neurological deficit. We consider this patient to be a case of transient NCSE due to influenza encephalopathy; alternatively, she may have epileptic traits and her NCSE may have been provoked by influenza virus infection.
Full Text of this Article in Japanese PDF (1838K)

(CLINICA NEUROL, 54: 227|230, 2014)
key words: non-convulsive status epilepticus (NCSE), influenza encephalopathy, influenza, IL-6, TNF-α

(Received: 15-Mar-13)