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. 1986 Jul;61(7):647–651. doi: 10.1136/adc.61.7.647

Recognition and early management of Reye's syndrome.

C A Dezateux, R Dinwiddie, P Helms, D J Matthew
PMCID: PMC1777889  PMID: 3740903

Abstract

Reye's syndrome continues to be associated with a high mortality. Out of 12 cases treated on our intensive care unit over a four year period, seven died, one suffered minimal cerebral damage, and four were normal. Rapid progression through coma stages and high peak ammonia concentrations worsened prognosis. Reye's syndrome was suspected in only 50% of cases at the referring hospital and resulted in prompt referral to the intensive care unit in only one case. Late referral to the unit was associated with a poor outcome. Sudden neurological deterioration followed diagnostic lumbar puncture in six children. Papilloedema was an unreliable sign of raised intracranial pressure and was absent in all cases. While computed tomography of the brain was useful in providing additional evidence of raised intracranial pressure, this could only be confirmed by direct measurement. Lumbar puncture in the presence of rapidly progressive coma should be deferred until raised intracranial pressure has been excluded. To this end, early admission to a paediatric intensive care unit with facilities for computed tomography and monitoring of intracranial pressure is recommended.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Byers R. K. To tap or not to tap (further comments). Pediatrics. 1973 Mar;51(3):561–561. [PubMed] [Google Scholar]
  2. Corey L., Rubin R. J., Bregman D., Gregg M. B. Diagnostic criteria for influenza B-associated Reye's syndrome: clinical vs. pathologic criteria. Pediatrics. 1977 Nov;60(5):702–708. [PubMed] [Google Scholar]
  3. Corey L., Rubin R. J., Hattwick M. A. Reye's syndrome: clinical progression and evaluation of therapy. Pediatrics. 1977 Nov;60(5):708–714. [PubMed] [Google Scholar]
  4. Fitzgerald J. F., Clark J. H., Angelides A. G., Wyllie R. The prognostic significance of peak ammonia levels in Reye syndrome. Pediatrics. 1982 Dec;70(6):997–1000. [PubMed] [Google Scholar]
  5. Glasgow J. F. Clinical features and prognosis of Reye's syndrome. Arch Dis Child. 1984 Mar;59(3):230–235. doi: 10.1136/adc.59.3.230. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Harper J. R., Lorber J., Hillas Smith G., Bower B. D., Eykyn S. J. Timing of lumbar puncture in severe childhood meningitis. Br Med J (Clin Res Ed) 1985 Sep 7;291(6496):651–652. doi: 10.1136/bmj.291.6496.651. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Lorber J., Sunderland R. Lumbar puncture in children with convulsions associated with fever. Lancet. 1980 Apr 12;1(8172):785–786. doi: 10.1016/s0140-6736(80)91290-8. [DOI] [PubMed] [Google Scholar]
  8. Lovejoy F. H., Jr, Bresnan M. J., Lombroso C. T., Smith A. L. Anticerebral oedema therapy in Reye's syndrome. Arch Dis Child. 1975 Dec;50(12):933–937. doi: 10.1136/adc.50.12.933. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Lovejoy F. H., Jr, Smith A. L., Bresnan M. J., Wood J. N., Victor D. I., Adams P. C. Clinical staging in Reye syndrome. Am J Dis Child. 1974 Jul;128(1):36–41. doi: 10.1001/archpedi.1974.02110260038007. [DOI] [PubMed] [Google Scholar]
  10. Sullivan-Bolyai J. Z., Corey L. Epidemiology of Reye syndrome. Epidemiol Rev. 1981;3:1–26. doi: 10.1093/oxfordjournals.epirev.a036229. [DOI] [PubMed] [Google Scholar]

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