Introduction: we have experienced a pandemic of influenza virus.  Many patients had CNS symptoms and lead to worse outcome leading to mortality and severe disability.  We present patients characteristics and course of the same.

Case report: Total of 5 patients from different geographic areas presented with acute febrile encepahalopathy and low GCS. All of them had hemorrhagic basal ganglia and brainstem lesions suggestive of viral encephalitis. Routine blood investigations were normal. High nasal swab for H1n1 was positive for all patients. Details of patients are shown in table. Patients were managed symptomatically with oral Fluvir and immunotherapy (IV Immunoglobulin). 3 out of 5 patients succumb to illness. 2 could survive the acute period.

Discussion: Majority of acute CNS infections are due to bacterial and viral etiology. Majority of them may not yield positive tests on PCR based assays. The course of CNS H1N1 disease is very fulminate due to affection of vital centers in CNS and multiorgan dysfunction. We treated all cases symptomatically and with IVIG considering cytokine storm.

Conclusion: hardly any literature is available for pediatric CNS H1N1 cases. This is short case series may reveal few aspects of the same. The outcome may be variable but supportive treatment and immunotherapy is key to prevent morbidity as well as mortality.