title: Pandemic influenza A (H1N1) 2009 with neurological manifestations, a case series.
abstract: OBJECTIVE
  Describe a series of atypical presentations of pandemic influenza A (H1N1) 2009.
  
  
  METHODS
  Description of case series using hospital records.
  
  
  RESULTS
  Six patients aged 1 to 65 years with confirmed pandemic influenza A (H1N1) 2009 infection presented with neurological complications within 2 to 5 days after the first signs of influenza-like illness. All six were admitted with seizures or altered mental status. No abnormalities were found in brain scans or cerebral spinal fluid studies of any of the six. All were discharged without sequelae within days of admission.
  
  
  CONCLUSIONS
  This is only the second report of pandemic influenza presenting with neurological manifestations. Clinicians caring for patients when pandemic influenza is prevalent in their communities should maintain a high level of awareness of the potential atypical presentations with which this disease can appear.
authors.affiliation: Department of Medicine, Clínica Alemana de Santiago, Clínica Alemana School of Medicine, Universidad del Desarrollo, Santiago, Chile.
authors.forename: Luis Miguel
authors.initials: LM
authors.lastname: Noriega
authors.forename: Renato J
authors.initials: RJ
authors.lastname: Verdugo
authors.forename: Rafael
authors.initials: R
authors.lastname: Araos
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Munita
authors.forename: Violeta
authors.initials: V
authors.lastname: Díaz
authors.forename: Alejandra
authors.initials: A
authors.lastname: Marcotti
authors.forename: Jorge
authors.initials: J
authors.lastname: Perez
authors.forename: Patricia
authors.initials: P
authors.lastname: Gonzalez
authors.forename: Luis
authors.initials: L
authors.lastname: Thompson
authors.forename: Magdalena
authors.initials: M
authors.lastname: Canals
authors.forename: Arnold
authors.initials: A
authors.lastname: Hoppe
authors.forename: Anthony W
authors.initials: AW
authors.lastname: Mounts
authors.forename: Pablo A
authors.initials: PA
authors.lastname: Vial
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003072:Cognition Disorders / Q000209:etiology*; D005260:Female; D006801:Humans; D007223:Infant; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000150:complications*; D008297:Male; D008875:Middle Aged; D012640:Seizures / Q000209:etiology*
references.citation: Clin Infect Dis. 2003 Mar 1;36(5):567-74
references.pmid: 12594636
references.citation: MMWR Morb Mortal Wkly Rep. 2009 Jul 24;58(28):773-8
references.pmid: 19629027
references.citation: Arch Intern Med. 2000 Apr 10;160(7):1041, 1045
references.pmid: 10761973
references.citation: Clin Infect Dis. 2002 Sep 1;35(5):512-7
references.pmid: 12173123
references.citation: Pediatrics. 2001 Oct;108(4):E63
references.pmid: 11581471
references.citation: Wkly Epidemiol Rec. 2009 Jul 24;84(30):305-8
references.pmid: 19630187
references.citation: Drug Saf. 2008;31(12):1097-114
references.pmid: 19026027
references.citation: Scand J Infect Dis. 1998;30(3):215-20
references.pmid: 9790126
references.citation: J Clin Virol. 2003 Dec;28(3):225-32
references.pmid: 14522059
references.citation: Pediatrics. 2004 Nov;114(5):e626-33
references.pmid: 15520093
references.citation: N Engl J Med. 2009 Jun 18;360(25):2605-15
references.pmid: 19423869
references.citation: MMWR Morb Mortal Wkly Rep. 2009 May 8;58(17):470-2
references.pmid: 19444151