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Reye's syndrome is an acute deterioration of brain tissue and brain function accompanied by a fatty degeneration of the liver and other organs. The cause of the disease remains unknown, but the syndrome often follows a viral infection such as influenza (flu), and some research has implicated the use of aspirin in these cases. Several recent studies have suggested that the rate of aspirin use in children and the incidence of Reye's syndrome have declined during the period of 1980 to 1985. At face value these data appear to support a relationship of aspirin use and Reye's syndrome. However, diagnostic practices have changed in the years since Reye's was first described and it is possible that, armed with current medical knowledge, a re-examination of prior cases could result in a re-classification of cases previously diagnosed as Reye's syndrome. Forty-nine cases, in which the patient was discharged or died, diagnosed as Reye's syndrome at one medical center over a 17-year period were reviewed by three clinicians. In 42 of the 49 cases (86 percent) there was agreement in diagnosing the patient's problem. In the remaining cases discussion among the clinicians resulted in the assignment of a diagnosis. The original diagnosis of Reye's syndrome was ranked certain in 1 case, probable in 11, and unlikely or excluded in 36 cases. This suggests that the actual occurrence of Reye's syndrome has always been low in this institution, and that the apparent reduction in the incidence of Reye's syndrome may be an artifact of prior mistaken diagnoses, rather than a result of decreased use of aspirin in treating children with viral infections. (Consumer Summary produced by Reliance Medical Information, Inc.)