Reye's syndrome (patient information)
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# Overview
Reye syndrome is sudden (acute) brain damage (encephalopathy) and liver function problems of unknown cause.
The syndrome has occurred with the use of aspirin to treat chickenpox or the flu in children. However, it has become very uncommon since aspirin is no longer recommended for routine use in children.

# What are the symptoms of Reye's syndrome?
Reye syndrome often begins with vomiting, which lasts for many hours. The vomiting is quickly followed by irritable and aggressive behavior. As the condition gets worse, the child may be unable to stay awake and alert.
Other symptoms of Reye syndrome:
- Confusion
- Lethargy
- Loss of consciousness or coma
- Mental changes
- Nausea and vomiting
- Seizures
- Unusual placement of arms and legs (decerebrate posture) -- the arms are extended straight and turned toward the body, the legs are held straight, and the toes are pointed downward
Other symptoms that can occur with this disorder include:
- Double vision
- Hearing loss
- Muscle function loss or paralysis of the arms or legs
- Speech difficulties
- Weakness in the arms or legs

# What causes Reye's syndrome?
Reye's syndrome is of unknown cause.

## Diseases with similar symptoms
Causes for similar symptoms include
- Various inborn metabolic disorders
- Viral encephalitis
- Drug overdose or poisoning
- Head trauma
- Hepatic failure due to other causes
- Meningitis
- Renal failure

# Who is at highest risk?
Reye syndrome is most often seen in children ages 4 - 12. Most cases that occur with chickenpox are in children ages 5 - 9. Cases that occur with the flu (influenzae type B) are usually in children ages 10 - 14.
Children with Reye syndrome get sick very suddenly. Reye syndrome usually follows an upper respiratory infection (URI) or chickenpox by about 1 week.

# Diagnosis
There are a range of tests, having varying accuracy. Some require only a blood sample while others require more invasive measures, such as a biopsy. The tests are:
- Blood chemistry tests
- Head CT or head MRI scan
- Liver biopsy
- Liver function tests
- Serum ammonia test
- Spinal tap

# When to seek urgent medical care?
Go to the emergency room or call the local emergency number (such as 911) immediately if your child has confusion, lethargy, or other mental changes.

# Treatment options
There is no specific treatment for this condition. The health care provider will monitor the pressure in the brain, blood gases, and blood acid-base balance (pH).
Treatments may include:
- Breathing support (a breathing machine may be needed during a deep coma)
- Fluids by IV to provide electrolytes and glucose
- Steroids to reduce swelling in the brain

# Where to find medical care for Reye's syndrome?
Directions to Hospitals Treating Reye's syndrome

# Prevention of Reye's syndrome
Never give a child aspirin unless told to do so by your doctor.
When a child must take aspirin, take care to reduce the child's risk of catching a viral illness such as the flu and chickenpox. Avoid aspirin for several weeks after the child has received a varicella(chickenpox) vaccine.
Other over-the-counter medications, such as Pepto-Bismol and substances with oil of wintergreen also contain aspirin compounds called salicylates. Do not give these to a child who has a cold or fever.

# What to expect (Outlook/Prognosis)?
Documented cases of Reyes syndrome in adults are rare. The recovery of adults with the syndrome is generally complete, with liver and brain function returning to normal within two weeks of the illness. In children, however, mild to severe permanent brain damage is possible, especially in infants. Over thirty percent of the cases reported in the United States from 1981 through 1997 resulted in fatality.

# Sources