title: Diverse seizure presentation of acute Mycoplasma pneumoniae encephalitis resolving with immunotherapy.
abstract: We report 3 previously normal children that presented for evaluation of new onset seizures. Case 1, a 7-year-old female, presented with refractory left frontal lobe seizures associated with right arm simple motor seizures refractory to 6 antiepileptic medications at sufficient doses and levels. Case 2, a 15-year-old female, presented with left frontotemporal lobe seizures and nonconvulsive seizures, associated with neuropsychiatric symptoms refractory to 5 antiepileptic medications. Both patients received intravenous steroids and intravenous immunoglobulin. Case 3, an 11-year-old male, presented with a generalized tonic clonic seizure and worsening hallucinations responding to intravenous corticosteroids and 1 antiepileptic medication. All 3 patients had extensive infectious and metabolic evaluation and were found to be serum immunoglobulin M positive for mycoplasma pneumoniae. Despite their prolonged severe symptoms, all patients had virtually complete recovery with excellent seizure control after aggressive seizure management with immunotherapy and antiepileptic medication.
authors.affiliation: 1Minnesota Epilepsy Group, St. Paul, MN, USA.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Arkilo
authors.forename: Beth
authors.initials: B
authors.lastname: Pierce
authors.forename: Frank
authors.initials: F
authors.lastname: Ritter
authors.forename: Jason S
authors.initials: JS
authors.lastname: Doescher
authors.forename: Michael
authors.initials: M
authors.lastname: Frost
mesh_terms: D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D002648:Child; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D008297:Male; D009177:Mycoplasma pneumoniae / Q000472:pathogenicity*; D011019:Pneumonia, Mycoplasma / Q000150:complications*; D012640:Seizures / Q000209:etiology / Q000382:microbiology / Q000628:therapy
chemical_list: D000927:Anticonvulsants
keywords: Mycoplasma pneumoniae encephalitis; immunotherapy; seizures