Reye's syndrome

Diagnosis

There's no specific test for Reye's syndrome. Screening usually begins with blood and urine tests. It also may include testing for fatty acid oxidation disorders and other disorders.

Sometimes other tests are needed to check for other possible causes of liver problems or problems with the nervous system. For example:

• Spinal tap, also known as a lumbar puncture. A spinal tap can help identify or rule out other diseases with similar symptoms. A spinal tap can uncover an infection of the lining that surrounds the brain and spinal cord, known as meningitis. Or it can help diagnose inflammation or an infection of the brain, called encephalitis.

  During a spinal tap, a needle is inserted through the lower back into a space between two bones. A small sample of the fluid that surrounds the brain and spinal cord is removed and sent to a lab for analysis.

• Liver biopsy. A liver biopsy can help identify or rule out conditions that may be affecting the liver. In people with Reye's syndrome, a liver biopsy can show a buildup of fats in liver cells.

  During a liver biopsy, a needle is inserted through the skin on the upper right side of the abdomen and into the liver. A small sample of liver tissue is removed and sent to a lab for analysis.

• CT scan or MRI. A head CT scan or MRI scan can help identify or rule out other causes of behavior changes or decreased alertness. These tests may show swelling in the brain, which may be caused by Reye's syndrome.

  A CT scan uses a series of X-rays taken from different angles to create a detailed image of the brain. An MRI scan uses a strong magnetic field and radio waves rather than X-rays to generate images of the brain.

Treatment

Reye's syndrome is usually treated in the hospital. Severe cases may be treated in the intensive care unit. The hospital staff will closely monitor your child's blood pressure and other vital signs. Specific treatment may include:

• Intravenous (IV) fluids. Sugar — also called glucose — and an electrolyte solution may be given through an IV line.
• Diuretics. These medicines may be used to decrease pressure from fluids around the brain. Diuretics also increase fluid loss through urination.
• Medicines to prevent bleeding. Bleeding due to liver problems may require treatment with vitamin K, plasma and platelets.
• Cooling blankets. These blankets help maintain internal body temperature at a safe level.

A breathing machine called a ventilator can help if your child has trouble breathing.

Preparing for your appointment

Reye's syndrome is often diagnosed in an emergency situation. This is because of the serious symptoms caused by Reye's syndrome, including seizures or loss of consciousness. In some cases, early symptoms prompt an appointment with a health care provider.

Your child is likely be referred to a specialist in conditions of the brain and nervous system, known as a neurologist.

Because appointments can be brief and there's often a lot to cover, it can help to be well prepared. Here are some tips to help you get ready for your appointment.

What you can do

• Be aware of any pre-appointment restrictions. At the time you make the appointment, ask if there's anything you need to do in advance.
• Write down any symptoms your child is experiencing, including any that may seem unrelated to the reason for which you scheduled the appointment.
• Make a list of all medicines, including vitamins, dietary supplements and medicines you can buy without a prescription that your child has taken. Be sure to list any medicines containing aspirin. Even better, take the original bottles and a written list of the dosages and directions.
• Take along a family member or friend. It can be difficult to recall all the information provided to you during an appointment. The person who accompanies you may remember something that you forgot or missed.
• Write down questions to ask your health care provider. Don't be afraid to ask questions or to speak up when you don't understand something your provider says.

List your questions from most important to least important to make the most of your time with your child's health care provider. For Reye's syndrome some basic questions to ask include:

• What are other possible causes for my child's symptoms?
• What tests are needed to confirm the diagnosis?
• What are the treatment options and the pluses and minuses for each?
• What results can I expect?
• What kind of follow-up should I expect?

In addition to the questions that you've prepared to ask your health care provider, don't hesitate to ask questions during your appointment.

What to expect from your doctor

The neurologist is likely to ask about your child's symptoms and history of viral illnesses. The neurologist also may conduct a medical exam and schedule tests to gather information about your child's condition and to rule out other diseases, such as meningitis or encephalitis.