Encyclopedia of Health and Medicine

280 The Nervous System
upper respiratory INFECTION, and INFLUENZA (the
flu). Researchers do not know what causes Reye’s
syndrome to develop though it is significantly
more likely to occur in children who receive
aspirin or bismuth subsalicylate (Pepto Bismol) to
treat the symptoms of their viral infections.
There is a strong correlation between
aspirin and other salicylates (such as
bismuth subsalicylate, better known as
the trade product Pepto Bismol) and
Reye’s syndrome in children. Do not
give these products to children who
may have viral infections.
Though Reye’s syndrome affects multiple organ
systems, the most serious consequence (and usually
the first indication of the syndrome’s appearance)
is ENCEPHALOPATHY (disturbances of BRAIN
function). Early diagnosis and aggressive therapeutic
intervention are essential to prevent or
manage metabolic and neurologic complications.
Reye’s syndrome can be fatal.
Symptoms and Diagnostic Path
The first symptoms of Reye’s syndrome are those
of encephalopathy developing within a week of a
viral infection. These symptoms include
• confusion
• memory disturbances
• agitation
• progressive UNCONSCIOUSNESS
Reye’s syndrome causes excessive deposits of
fatty acids in the LIVER; thus liver biopsy provides
the definitive diagnosis. The deposits interfere
with the liver’s ability to function, resulting in systemic
metabolic disturbances, such as electrolyte
and enzyme imbalances, that are apparent from
BLOOD tests. Deposits of fatty acids may accumulate
in other organs as well, such as the HEART, KIDNEYS,
and PANCREAS.
Treatment Options and Outlook
A child who has Reye’s syndrome requires hospitalization
in the intensive care unit. Because the
cause of Reye’s syndrome remains unknown,
treatment is supportive and aims to manage the
constellation of metabolic disturbances that typify
the syndrome. These metabolic disturbances often
cause serious complications such as ARRHYTHMIA
(abnormal electrical activity in the heart) and
HYPOTENSION (low BLOOD PRESSURE). Kidney function
also may suffer, leading to RENAL FAILURE.
Overall about 75 percent of children survive
Reye’s syndrome; about two thirds of survivors
have no long-term consequences. When such
consequences occur, they may include SEIZURE DIS-
ORDERS, intellectual impairment, and neuromuscular
dysfunction. The later the stage of Reye’s
syndrome at the time of diagnosis, the higher the
risk for complications, including death.
Risk Factors and Preventive Measures
Reye’s syndrome occurs nearly exclusively in children
under age 15 years and develops during the
course of a viral infection. IMMUNIZATION for
influenza and chickenpox can prevent these infections,
which are commonly associated with Reye’s
syndrome. There are no known measures for preventing
Reye’s syndrome. Early diagnosis and
aggressive treatment are essential for optimal
recovery.
See also CHILDHOOD DISEASES.
rhizotomy A surgical OPERATION to selectively
sever segments (rootlets) of the dorsal (back) or
ventral (front) roots of a spinal NERVE to treat
intractable and debilitating PAIN or spasticity such
as may occur with neuromuscular disorders. The
operation reduces the number of nerve impulses
the nerve roots convey. Rhizotomy may be an
appropriate treatment for CEREBRAL PALSY, SPINAL
CORD INJURY, and other conditions that generate
DYSTONIA, CHOREA, or ATHETOSIS. Rhizotomy generally
becomes a therapeutic option only when
other methods have failed to control symptoms,
though may be an earlier recommendation for
certain presentations of spastic cerebral palsy. The
neurosurgeon performs the operation with the
person under general ANESTHESIA. Risks and complications
of rhizotomy include excessive bleeding,
postoperative INFECTION, altered sensory perception
in the affected limb (usually foot or leg), and,
rarely, PARALYSIS.
See also BOTULINUM THERAPY; SURGERY BENEFIT AND
RISK ASSESSMENT.