Table 3.
Laboratory investigations, neuroimaging and EEG findings of the children with neurological complications of H1N1 virus infection at Evelina Children’s Hospital
| Case 1 | Case 2 | Case 3 | Case 4 | Case 5 | |
|---|---|---|---|---|---|
| C reactive protein (mg/L) | 11 | 25 | 10 | 16 | 46 |
| Blood culture | No growth | No growth | No growth | No growth | No growth |
| Urine culture | No growth | No growth | No growth | No growth | No growth |
| CPK (IU/l) | 200 | Not done | 691 | 929 | 32 |
| AST (IU/l) | 22 | 23 | 25 | 65 | 16 |
| MRI brain | Non-specific parietal–occipital white matter changes with minimal acute inflammation | High signal involving the dentate nuclei, pons, midbrain and thalami | Initial: normal; at 2 months: subtle and vague increased signal in a periventricular distribution bilaterally | Initial: normal; at 3 weeks: significant loss of cerebral volume | CT brain normal |
| EEG | Background 1–2 Hz slow wave activity | Generalised high-amplitude 1–2-Hz delta activity | High-amplitude generalised slow waves with no epileptiform discharges | 1–2.5 Hz slow background activity with no epileptiform activity | Not done |
| CSF | |||||
| White cell | <1 | <1 | 16a | <1 | 1 |
| Red cell | <1 | <1 | 1 | 5 | 10 |
| Protein (g/l) | 0.29 | 0.53 | 0.2 | 0.07 | 0.12 |
| Glucose (mmol/l) | 3.6 | 3.6 | 3.8 | 4 | 3.3 |
| Culture | No growth | No growth | No growth | No growth | No growth |
| H1N1 PCR | Negative | Negative | Negative | Negative | Negative |
| Oligoclonal bands | Not done | Negative | Not done | Negative | Not done |
CK creatine phosphokinase, AST aspartate aminotransferase, CSF cerebrospinal fluid
aRepeat CSF was normal (4, white cell; 65, red cell)