Respiratory Syncytial Virus, or RSV, is a common respiratory virus that infects the lungs and airways. Nearly all children encounter the virus by the age of two, with symptoms often presenting as a mild cold, including a runny nose, cough, and sometimes a low-grade fever. For infants and young children, the infection can progress to more serious lower respiratory tract illnesses, such as bronchiolitis or pneumonia. While most cases resolve with supportive care, severe illness can lead to complications extending beyond the respiratory system, including potential neurological effects.
Understanding the Connection Between RSV and Seizures
RSV can cause seizures in children, although this is a relatively infrequent complication. Seizures are the most commonly reported neurological feature when RSV affects the nervous system, occurring in a small fraction of children hospitalized with the virus (approximately 1% to 3% of cases).
Seizures associated with RSV typically occur during the acute phase of the illness, often coinciding with the peak of fever and respiratory distress. Most of these events are classified as febrile seizures, triggered by a rapid increase in body temperature. However, some children experience non-febrile seizures, suggesting a more direct involvement of the virus or the body’s inflammatory response.
Neurological Mechanisms Behind RSV-Related Seizures
The majority of RSV-associated seizures are febrile seizures, which are convulsions caused by a fever that does not involve a central nervous system infection. Children between six months and five years are most susceptible to these events. These seizures typically last less than 15 minutes and do not cause lasting harm to the brain.
Beyond fever, severe RSV infection can provoke non-febrile seizures through several distinct mechanisms. The virus triggers a robust immune response that releases pro-inflammatory molecules, such as cytokines, which can lead to neuroinflammation. This inflammation can disrupt normal brain function and lower the seizure threshold.
In rarer, more severe instances, the virus may directly affect the central nervous system, leading to encephalopathy or encephalitis. Encephalopathy involves a temporary change in brain function, sometimes linked to cytotoxic edema, where cells swell due to fluid buildup. The virus or the resulting inflammation may breach the protective barriers of the central nervous system. Furthermore, complications such as severe respiratory distress or dehydration may induce metabolic disturbances, including hyponatremia (low sodium levels), which is a known trigger for seizures.
Recognizing and Responding to Seizures in Children
Recognizing a seizure involves noticing signs like sudden loss of consciousness, uncontrolled jerking or stiffening of the limbs, or a blank stare. The event may also include a temporary loss of bladder or bowel control. The first priority is to prevent injury by gently lowering the child to the floor and clearing away any nearby hazards.
Once the child is safe, immediately turn them onto their side to help prevent choking on saliva or vomit. Do not restrain the child or attempt to put anything into their mouth, as this can cause injury. Time the duration of the seizure, as this information is crucial for medical professionals.
Immediate medical attention is necessary if the seizure lasts longer than five minutes, or if the child has trouble breathing during or after the event. Calling emergency services is also recommended if it is the child’s first seizure, even if it is brief. After the event concludes, the child will likely be sleepy or confused, and they should be allowed to rest until they are fully alert.
Identifying Children at Highest Risk
Children who face the highest risk for severe complications from RSV, including seizures, are generally those who are already vulnerable. Infants are disproportionately affected, with the highest risk found in those under six months of age.
Specific underlying health conditions also elevate the risk for severe RSV outcomes and neurological complications. Seizures are most often observed in children whose RSV infection is severe enough to require hospitalization or intensive care unit admission.
High-Risk Conditions
- Infants born prematurely
- Children with chronic lung conditions, such as chronic lung disease of prematurity
- Children with congenital heart defects
- Children with weakened immune systems or pre-existing neurological or neuromuscular disorders