Two young girls from the Ramat Hasharon area had strokes after contracting swine flu, Meir Hospital in Kfar Sava reported yesterday.

These are the first reported cases in the world of strokes following infection with H1N1, otherwise known as swine flu.

Adar Kashi from Kfar Yona, who will be 11 next month, was hospitalized in early December at Meir after she fell out of bed and had trouble walking and talking. She also exhibited flu symptoms.

"They did a throat culture and she received medication that didn't help. One night I heard her yell. I went into her room and saw her lying on the floor paralyzed on her right side and confused," her mother, Ilana, said.

Adar was taken to the emergency room, where an MRI revealed the stroke. Concern over the possibility of swine flu led to her being treated with the antiviral medication Tamiflu and she subsequently tested positive for the disease.

"Any other factor that could have been responsible for the stroke was ruled out," Dr. Giora Gottesman, a pediatrician and infectious diseases specialist at Meir Hospital, said.

Adar is now undergoing rehabilitation and is slowly regaining lost functions.

The other girl, 11, is from an Arab village in the Triangle area of central Israel who was hospitalized in November after she became paralyzed. An MRI did not reveal conclusive evidence of a stroke, but did reveal damage to part of her brain. She was hospitalized for two weeks and returned home with her functioning restored.

The medical literature has documented a few cases of stroke following infection with seasonal flu.

In 2004 researchers in Calgary, Canada, reported that between 1994 and 2001, an increase in strokes occured regularly about 20 weeks following changes in the contraction of flu in the district.

In an article in the medical journal "Neuroepidemiology," the researchers concluded that a small number of the cases could be explained by changes in the activities of seasonal viruses.

Certain cerebral infections have been associated with swine flu, including four cases in the United States and one in Argentina.

Gottesman said the hospital plans on writing up the two cases as soon as possible in a medical journal.

"We know that a stroke is caused by over-clotting or abnormal blood vessels in the brain and if no other connection is found, it may be assumed that there is a connection to swine flu," said Prof. Dan Engelhard of Hadassah University Hospital, Ein Karem, who heads the medical team advising the Health Ministry on epidemics and swine flu.

So far 74 people have died of swine flu in Israel, among them five patients with no particular health problems.

A 29-year-old woman is in serious condition in Hadassah Hospital with a secondary bacterial infection in the brain following swine flu, Engelhard said.