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Reye Syndrome

What is Reye syndrome?

Reye syndrome is a rare condition that affects the normal chemical balance in the body, resulting in potential damage to all organs, but primarily affecting the brain and liver. This condition is most common in children and adolescents following a viral infection. Reye syndrome usually affects children between the ages of 4 and 12, although it can occur at any age.

As the inflammation in the brain increases, the pressure inside of the head may also increase. The increased pressure in the head causes neurological changes in the child.

It has a very rapid onset that can cause the child to go into a coma, or can result in death within hours of the symptoms.

What causes Reye syndrome?

The exact cause of Reye syndrome is unknown. The more common cases of Reye syndrome occur in conjunction with a previous viral infection, such as the flu or chicken pox.

Studies show that there is an association between the ingestion of products containing aspirin in children who have a viral illness and Reye syndrome. As a result, the CDC and the American Academy of Pediatrics have released warnings to the public about the relationship between aspirin and Reye syndrome. Parents should not give aspirin to children unless instructed by your child's doctor. The incidence of Reye syndrome has fallen since these recommendations were adopted in the 1980s, but it is not clear if factors other than aspirin are involved, such as specific strains of influenza that triggered Reye syndrome.

What are the symptoms of Reye syndrome?

The following are the most common symptoms of Reye syndrome. A child may have had a viral illness such as a respiratory infection, chickenpox, or diarrhea before experiencing symptoms of Reye syndrome. Symptoms may include:

  • A full or bulging fontanelle (a soft spot on the top of the head in infants)

  • Sleepiness or lethargy

  • Sudden and prolonged vomiting

  • Combative behavior

  • Rapid breathing and heart rate

  • Seizures

  • Coma

  • Increased intracranial pressure

  • Increased irritability

  • High-pitched cry

The symptoms of Reye syndrome may look like other conditions or medical problems. Always consult your child's doctor for a diagnosis.

How is Reye syndrome diagnosed?

The diagnosis of Reye syndrome is made after the sudden onset of specific symptoms and after diagnostic testing. During a physical exam, your child's doctor will take a complete medical history of your child. Your child's doctor may also ask if the child has recently had a cold or other viral illness, and whether the child has taken aspirin or medication containing aspirin.

Diagnostic tests that may be done to confirm the diagnosis of Reye syndrome include the following:

  • Blood and liver function tests

  • Urine and stool tests

  • Liver biopsy. A small amount of tissue is removed from the liver and studied to help diagnose different illnesses.

  • Electroencephalogram (EEG). A procedure that records the brain's continuous, electrical activity by means of electrodes attached to the scalp.

  • Lumbar puncture (spinal tap). A special needle is placed into the lower back, into the spinal canal. This is the area around the spinal cord. The pressure in the spinal canal and brain can then be measured. A small amount of cerebral spinal fluid (CSF) can be removed and sent for testing to determine if there is an infection or other problems. CSF is the fluid that bathes your child's brain and spinal cord.

  • Intracranial pressure monitoring (ICP). Measures the pressure inside of the child's head.

  • Magnetic resonance imaging (MRI). A diagnostic procedure that uses a combination of a large magnet, radiofrequencies, and a computer to produce detailed images of organs and structures within the body.

Treatment of Reye syndrome

Your child’s health care provider will figure out the best treatment based on:

  • How old your child is

  • His or her overall health and medical history

  • How sick he or she is

  • How well your child can handle specific medications, procedures, or therapies

  • How long the condition is expected to last

  • Your opinion or preference

Although there is no cure for Reye syndrome, there are some treatment options. The key to medically managing Reye syndrome is early detection.

A child with Reye syndrome requires immediate hospitalization in the intensive care unit and close monitoring by the health care team. This is a serious illness that can quickly worsen.

The goal of treatment is to monitor and reduce the pressure in the head and to provide supportive care (treatment of symptoms) to the child. Medications are used to control the inflammation in the brain, seizures, fever, or other conditions that may be present.

The extent of the problem is dependent on the severity of the condition and the presence of other organ system problems that could affect the child. In severe cases, a breathing machine may be required to help the child breathe easier.

Prevention of Reye syndrome

Parents should read medication labels carefully and avoid giving children products containing aspirin during times of illness. Consult your child's doctor for questions regarding medications and dosage.

Medical Reviewers:

  • MMI board-certified, academically affiliated clinician
  • Turley, Ray, BSN, MSN