Neurologic manifestations of Schoenlein-Henoch purpura: report of three cases and review of the literature.
Three patients developed prominent neurologic symptoms and signs associated with Schoenlein-Henoch purpura. A 7 1/2-year-old boy was seen with status epilepticus after a 2-week history of generalized headaches, irritability, and intermittent colicky abdominal pain. A left hemiparesis and a left homonymous hemianopia with a right gaze preference that were present on initial examinations gradually resolved, but a mild left arm paresis persisted. Cutaneous, renal, and joint involvement followed initial CNS manifestations. The second patient, a 7-year-old girl, had a complex partial seizure with secondary generalization and a postictal hemiparesis seven days after presentation with classic signs of Schoenlein-Henoch purpura. Behavioral changes were noted during the acute phase of the illness. The third patient, a 13-year-old boy, developed signs of a left brachial plexopathy and transient weakness of his right leg during a complicated course of Schoenlein-Henoch purpura. Review of the world literature indicates that headaches and mental status changes are the most frequent neurologic complications of Schoenlein-Henoch purpura, followed by seizures, focal neurologic deficits, mononeuropathies, and polyradiculoneuropathies. The vasculitis of Schoenlein-Henoch purpura can involve the nervous system and may add significantly to the morbidity of the illness.
Belman
A L
AL
Leicher
C R
CR
Moshé
S L
SL
Mezey
A P
AP
D000293:Adolescent; D001519:Behavior; D001927:Brain Diseases / Q000209:etiology; D002648:Child; D004569:Electroencephalography; D004644:Emotions; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications* / Q000473:pathology; D008297:Male; D009422:Nervous System Diseases / Q000209:etiology* / Q000473:pathology; D010243:Paralysis / Q000209:etiology; D010523:Peripheral Nervous System Diseases / Q000209:etiology; D012640:Seizures / Q000209:etiology; D013226:Status Epilepticus / Q000209:etiology