title: Paroxysmal autonomic instability with dystonia after pneumococcal meningoencephalitis.
abstract: Streptococcus pneumoniae is a common cause of bacterial meningitis, frequently resulting in severe neurological impairment. A seven-month-old child presenting with Streptococcus pneumoniae meningoencephalitis developed right basal ganglia and hypothalamic infarctions. Daily episodes of agitation, hypertension, tachycardia, diaphoresis, hyperthermia, and decerebrate posturing were observed. The diagnosis of paroxysmal autonomic instability with dystonia was established. The patient responded to clonidine, baclofen, and benzodiazepines. Although this entity has been reported in association with traumatic brain injury, and as a sequel to some nervous system infections, this is the first case, to our knowledge, associated with pneumococcal meningoencephalitis.
authors.affiliation: Division of Neurology, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, P.O. Box 11-0236, Riad El Solh, Beirut 1107 2020, Lebanon.
authors.forename: Layal
authors.initials: L
authors.lastname: Safadieh
authors.forename: Rana
authors.initials: R
authors.lastname: Sharara-Chami
authors.forename: Omar
authors.initials: O
authors.lastname: Dabbagh