What is the CDC classification of Reye syndrome?

Updated: Apr 02, 2018
  • Author: Debra L Weiner, MD, PhD; Chief Editor: Kirsten A Bechtel, MD  more...
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Lovejoy initially divided Reye syndrome into clinical stages 1-5 [6] ; Hurwitz subsequently developed a modified classification that divided the syndrome into stages 0-5, including a nonclinical stage (ie, stage 0). The CDC uses the Hurwitz classification but adds stage 6. Stage 0 does not meet the CDC case definition, because it does not meet the criteria for encephalopathy (see DDx). The stages used in the CDC classification of Reye syndrome are as follows:

  • Stage 0 - Alert, abnormal history and laboratory findings consistent with Reye syndrome, and no clinical manifestations

  • Stage 1 - Vomiting, sleepiness, and lethargy

  • Stage 2 - Restlessness, irritability, combativeness, disorientation, delirium, tachycardia, hyperventilation, dilated pupils with sluggish response, hyperreflexia, positive Babinski sign, and appropriate response to noxious stimuli

  • Stage 3 - Obtunded, comatose, decorticate rigidity, and inappropriate response to noxious stimuli

  • Stage 4 - Deep coma, decerebrate rigidity, fixed and dilated pupils, loss of oculovestibular reflexes, and dysconjugate gaze with caloric stimulation

  • Stage 5 - Seizures, flaccid paralysis, absent deep tendon reflexes (DTRs), no pupillary response, and respiratory arrest

  • Stage 6 - Patients who cannot be classified because they have been treated with curare or another medication that alters the level of consciousness

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