title: Levodopa treatment of late onset extrapyramidal movements in a child after high voltage electrocution.
abstract: We present the case of a 12-year-old girl with abnormal extrapyramidal movements associated with basal ganglia lesions after electrical injury. After her injury, our patient initially did well and recovered from acute cardiovascular and hemodynamic instability, and the results of her neurological examination, head computed tomography scan, and electroencephalogram were normal on discharge from hospital. Two weeks after discharge, she developed extrapyramidal movements, and head magnetic resonance imaging showed areas of bilateral, symmetrical enhanced associated with signal intensity in the basal ganglia, hypoxic encephalopathy, and cerebral edema that may have occurred secondary to the cardiopulmonary arrest that she suffered immediately after her accident. The symptoms disappeared after low dose levodopa was instituted and have not recurred during the 15 months of treatment. Injury and death from electric current, although rare, are not uncommon and occur mostly as a result of accidental contact with a live wire. This is the first case report documenting the use of levodopa for extrapyramidal movements secondary to high-tension electrocution.
authors.affiliation: 1Division of Pediatric Emergency Medicine, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Ontario, Canada; 2Division of Clinical Pharmacology and Toxicology, Department of Pediatrics, the Hospital for Sick Children, University of Toronto, Ontario, Canada; 3Intensive Care Unit, "Hospital del Niño de San Justo," Buenos Aires, Argentina; 4Pediatric Neurology Department, Institute of Cognitive Neurology (INECO), Buenos Aires, Argentina; 5Institute of Neurosciences, Favaloro University, Buenos Aires, Argentina; and 6Neurology Department "Hospital del Niño de San Justo," Buenos Aires, Argentina.
authors.forename: Miguel
authors.initials: M
authors.lastname: Glatstein
authors.forename: Dennis
authors.initials: D
authors.lastname: Scolnik
authors.forename: Eduardo
authors.initials: E
authors.lastname: Mari
authors.forename: Matías
authors.initials: M
authors.lastname: Penazzi
authors.forename: Graciela
authors.initials: G
authors.lastname: Ruiz
authors.forename: Claudio
authors.initials: C
authors.lastname: Waisburg
mesh_terms: D001479:Basal Ganglia / Q000293:injuries; D001480:Basal Ganglia Diseases / Q000188:drug therapy* / Q000209:etiology*; D002648:Child; D004556:Electric Injuries / Q000150:complications*; D004569:Electroencephalography; D005260:Female; D006323:Heart Arrest / Q000150:complications*; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use*; D014057:Tomography, X-Ray Computed
chemical_list: D007980:Levodopa