title: Neurological and muscular manifestations associated with influenza B infection in children.
abstract: BACKGROUND
  Influenza viruses have been associated with various neurological and muscular symptoms. The aim of this study was to evaluate the pediatric neurological and muscular manifestations of influenza B during a 5-month epidemic at a single center.
  
  
  METHODS
  We retrospectively reviewed the medical records of 355 pediatric patients with laboratory-confirmed influenza B infection.
  
  
  RESULTS
  Neurological and muscular symptoms were exhibited by 28 patients (7.9%). The mean age was 48.7 ± 25.2 months. The mean time between respiratory symptoms and neurological symptoms was 2.2 ± 1.5 days. The most common symptom was seizure (19/28, 67.9%), followed by myositis (5/28, 17.9%), increased intracerebral pressure (1/28, 3.6%), delirium (1/28, 3.6%), and severe headache (1/28, 3.6%). There was one severe case of meningitis with myocarditis (1/28, 3.6%). All seizures were febrile: 15 simple febrile seizures (78.9%), three complex febrile seizures (15.8%), and one febrile status epilepticus (5.3%). The mean age of nine patients with their first seizures was 37.9 ± 22.2 months, which was older than the typical age of onset for febrile seizure. All the patients, except one, were treated with oseltamivir. There were no deaths or chronic debilitating sequelae.
  
  
  CONCLUSIONS
  The neurological and muscular complications of influenza B infection in children are relatively mild, and febrile seizure is the most common. However, clinicians should be alert to the possibility of rare severe complications during influenza B outbreaks.
authors.affiliation: Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea. jhmoon@hyumc.com
authors.forename: Jin-Hwa
authors.initials: JH
authors.lastname: Moon
authors.forename: Jae-Yoon
authors.initials: JY
authors.lastname: Na
authors.forename: Joo-Hwa
authors.initials: JH
authors.lastname: Kim
authors.forename: Myung-Kul
authors.initials: MK
authors.lastname: Yum
authors.forename: Jae-Won
authors.initials: JW
authors.lastname: Oh
authors.forename: Chang-Ryul
authors.initials: CR
authors.lastname: Kim
authors.forename: In Joon
authors.initials: IJ
authors.lastname: Seol
mesh_terms: D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D009981:Influenza B virus / Q000235:genetics / Q000472:pathogenicity*; D007251:Influenza, Human / Q000150:complications*; D008297:Male; D009135:Muscular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000821:virology; D009422:Nervous System Diseases / Q000145:classification / Q000175:diagnosis / Q000209:etiology* / Q000821:virology; D016759:Oncogene Protein p65(gag-jun) / Q000235:genetics / Q000378:metabolism; D012189:Retrospective Studies
chemical_list: D016759:Oncogene Protein p65(gag-jun)