Title:Neurological Manifestations of Influenza Virus and RSV Infections in Children
Volume: 21
Issue: 1
Author(s): Federica Xerra, Giulia Cafarella, Federica Ferrante, Gaetano Macchione, Melania Amato, Cecilia Lugarà, Simone Foti Randazzese, Antonella Gambadauro*Ylenia Giorgianni
Affiliation:
- Pediatric Unit, Department of Human and Pediatric Pathology "Gaetano Barresi", AOUP G. Martino, University of
Messina, Via Consolare Valeria 1, Messina, 98124, Italy
Keywords:
Neurological infection, cognitive impairment, seizures, encephalopathy, sequelae, synaptic cleft and influenza virus, RSV.
Abstract: The most significant viral contributors to acute respiratory tract infections in children
are Respiratory Syncytial Viruses (RSV) and influenza virus, causing substantial seasonal respiratory
infections annually. Furthermore, severe neurological complications, notably seizures and encephalopathy,
can be attributed to these viruses. Children with chronic or pre-existing neurological
conditions are particularly susceptible to increased morbidity and sequelae. An active area of
research to date is focused on the potential mechanisms of viral neurological invasion, which
could be relevant for future therapeutic strategies. Influenza virus is frequently an important cause
of epidemic or pandemic disease causing high costs of hospitalization and primary care. Furthermore,
different subtypes of influenza viruses can induce various influenza-associated neurological
complications, varying from mild (i.e., headache) to severe (i.e., meningoencephalitis and acute
necrotizing encephalopathy), both in adults and children. While affecting the respiratory tract,
RSV can also give rise to neurological manifestations, potentially resulting in long-term neurological
impairment. Neurological changes associated with RSV encompass seizures, lethargy, ataxia,
febrile or epileptic states, central apnea, difficulties in feeding or swallowing, tone abnormalities,
strabismus, abnormalities in cerebrospinal fluid, and encephalopathy. Patients infected with RSV
can also develop neuromotor difficulties or present learning impairment. In conclusion, viral respiratory
infections can result in significant extrapulmonary symptoms, potentially leading to enduring
health consequences in affected children. Substantial research efforts are necessary to prevent
or treat these infections, particularly within the most vulnerable populations.
