title: [Lethargic encephalitis. Report of one case].
abstract: Lethargic encephalitis (LE) is a Central Nervous System disorder following an upper respiratory tract infection, characterized by sleep disturbances, clinical symptoms corresponding to basal ganglia involvement and in some cases, neuropsychiatric sequelae. We report a 18-year-old mole with a history of sinusitis treated with azithromycin, two weeks before, presenting with fever, headache, confusion and myoclonus. Urine analysis was positive for cannabis. Cerebro spinal fluid analysis showed mononuclear pleiocytosis (109xmm³) and an increase in protein concentration of l.6 g/dl. Forty eight hours after admission, the patient required mechanical ventilation and subsequently a status epilepticus appeared. Ten days later, fever, rigidity and resting tremor appeared. A magnetic resonance imaging showed hyperintensities in FLALR sequence in the right insular cortex. The patient continued with extreme rigidity, catatonia and mutism. Considering the possibility ofa LE, methyl prednisolone 1 g/day was administered for five consecutive days followed by prednisone 40 mg l day, observing a dramatic improvement of rigidity and tremors.
authors.affiliation: Servicio de Clínica Médica, Hospital Británico de Buenos Aires, Argentina.
authors.forename: Sabrina F
authors.initials: SF
authors.lastname: Vadalá
authors.forename: Débora
authors.initials: D
authors.lastname: Pellegrini
authors.forename: Emanuel D
authors.initials: ED
authors.lastname: Silva
authors.forename: Diego
authors.initials: D
authors.lastname: Miñarro
authors.forename: Bárbara C
authors.initials: BC
authors.lastname: Finn
authors.forename: Julio E
authors.initials: JE
authors.lastname: Bruetman
authors.forename: Gabriel
authors.initials: G
authors.lastname: Nápoli
authors.forename: Pablo
authors.initials: P
authors.lastname: Young
mesh_terms: D000293:Adolescent; D004359:Drug Therapy, Combination; D004660:Encephalitis / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010301:Parkinson Disease, Postencephalitic / Q000175:diagnosis* / Q000188:drug therapy