1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-7-41 10.15844/pedneurbriefs-7-6-1 Infectious Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Exanthem Subitum CNS Complications http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 06 1993 01 07 2016 7 6 41 42 Copyright: © 1993 The Author(s) 1993 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Clinical and virological analyses of 21 infants with exanthem subitum (roseola infantum) and central nervous system complications

Central nervous system (CNS) complications of exanthem subitum were analyzed in 21 infants examined at the Departments of Pediatrics and Neurology, Fujita Health University School of Medicine, Toyoake, Japan.

 Central Nervous System Exanthem Subitum Encephalitis/Encephalopathy

Central nervous system (CNS) complications of exanthem subitum were analyzed in 21 infants examined at the Departments of Pediatrics and Neurology, Fujita Health University School of Medicine, Toyoake, Japan. The primary infection with human herpesvirus 6 was confirmed by isolation of the virus from the blood and/or a rise in antibody titers, and the virus DNA was detected in the cerebrospinal fluid of 6 infants, including 3 with encephalitis/encephalopathy (E/E). Convulsive seizures (15 generalized and 6 focal) occurred during the pre-eruptive stage of the illness, and persisted for more than 45 minutes in 7 infants. Four patients with E/E had prolonged focal seizures and loss of consciousness, abnormal EEGs and CT scans; 3 had a pleocytosis and elevated protein in the CSF. One developed epilepsy and one died. Infants without E/E recovered with no sequelae. [1]

COMMENT. Exanthem subitum is a common, usually benign, infectious disease of infants, characterized by a four day fever and a rash that appears after the fever subsides. Seizures may complicate the illness during the febrile stage and before the rash erupts. Human herpesvirus 6, recently identified as the causative agent, may rarely invade the CNS and cause encephalitis.

A febrile seizure has long been recognized as the most common complication of exanthem subitum, occurring in 22 percent of 581 patients reported in 11 publications [2]. Evidence for an encephalitic process and a direct involvement of the brain was lacking, and the degree of fever was considered sufficient to explain the frequent complication of convulsions. The present report demonstrates that seizures associated with exanthem subitum and fever are not always simple in type. They are occasionally prolonged and complex and a manifestation of encephalitis or encephalopathy.

 Suga S Yoshikawa T Asano Y Kozawa T Nakashima T Kobayashi I Clinical and virological analyses of 21 infants with exanthem subitum (roseola infantum) and central nervous system complications Ann Neurol 1993 Jun 33 6 597 603 8388679 10.1002/ana.410330607 Millichap JG Febrile Convulsions 1968 New York Macmillan