[A case of adult Reye's syndrome with favorable outcome despite status epilepticus].
A case of adult Reye's syndrome is described. A previously healthy 17-year-old man developed convulsions 2 days after resolution of an upper respiratory infection with parainfluenza virus type 3. During the preceding infection, he took aspirin. On admission, he was drowsy. There was no focal signs. Cranial CT scan was unremarkable. A lumbar puncture revealed an opening pressure of 180 mm H2O; the cerebrospinal fluid was acellular with normal protein level. Serum chemistry showed elevated transaminase activities and normal bilirubin level. Blood ammonia level was high; urea and citrulline levels were abnormally low. These abnormalities disappeared later, suggesting transient cysfunction of mitochondrial urea-cycle enzymes. Free and acyl carnitine levels were unremarkable. Both metabolic acidosis and ketonuria were absent. Thus, a variety of aminoacidurias and organic acidemias are unlikely. All these findings meet diagnostic criteria for Rye's syndrome proposed by the CDC of the USA. Status epilepticus was treated with intravenous infusion of thiamylal sodium. He was treated with hypertonic glucose solution and osmotic diuretic. Three months after the onset of the illness, his convulsions were controlled only with zonisamide, clonazepam, and carbamazepine. He had motor dysfunctions. This case is unique in that a patient with adult Reye's syndrome and status epilepticus favorably recovered.
Arai
M
M
Department of Neurology, Seirei Mikatabara General Hospital.
D000293:Adolescent; D000927:Anticonvulsants / Q000008:administration & dosage; D006801:Humans; D008297:Male; D010634:Phenobarbital / Q000008:administration & dosage; D012202:Reye Syndrome / Q000150:complications* / Q000378:metabolism; D013226:Status Epilepticus / Q000188:drug therapy / Q000209:etiology*
D000927:Anticonvulsants; D010634:Phenobarbital