Acute encephalopathy and intractable seizures in a 10-year-old boy.
We report a 10-year-old child with Robinow's syndrome who had a 2-week history of headaches and dizziness. On the day of admission, he developed a focal onset seizure with rapid secondary generalization. The seizures were intractable despite adequate doses of benzodiazepine, phenytoin, and phenobarbital, requiring a pentobarbital drip. Continuous electroencephalogram (EEG) monitoring showed persistence of the epileptiform discharges for 13 days. Cerebrospinal fluid and brain biopsy studies were unrevealing. Mycoplasma pneumonia titers showed elevation of both immunoglobulins G and M that doubled during the tenth hospital day. High-dose methylprednisolone was begun, and within 12 hours of initiation the patient sat up and began to follow commands appropriately. The overall EEG background markedly improved. Central nervous system Mycoplasma pneumoniae infection should be suspected in patients with an encephalopathy of unclear etiology.
Caceres
M E
ME
Department of Pediatrics, Robert C. Byrd Health Sciences Center of West Virginia University/Charleston Division, USA.
de los Reyes
E C
EC
Khan
R
R
Caceres
M J
MJ
D000208:Acute Disease; D002648:Child; D003128:Coma / Q000175:diagnosis; D004569:Electroencephalography; D018792:Encephalitis, Viral / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D009175:Mycoplasma Infections / Q000150:complications; D009177:Mycoplasma pneumoniae / Q000302:isolation & purification; D012640:Seizures / Q000175:diagnosis* / Q000209:etiology*