title: Insult to injury: transient encephalopathy in a brain-injured adolescent.
abstract: We report on an adolescent with prior brain injury who responded to abrupt drug changes and an electrolyte imbalance with a significant alteration in the level of consciousness. In children with prior brain injury, paediatricians should consider the concept of a 'fragile brain' with limited 'cognitive reserve' and increased susceptibility to relatively minor toxic-metabolic insults. Psychoactive and central nervous system drugs should be managed with prudence in these patients.
authors.affiliation: Department of Neurology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts, United States.
authors.forename: Jurriaan M
authors.initials: JM
authors.lastname: Peters
authors.forename: Iván Sánchez
authors.initials: IS
authors.lastname: Fernández
mesh_terms: D000293:Adolescent; D001928:Brain Diseases, Metabolic / Q000175:diagnosis* / Q000209:etiology; D001930:Brain Injuries / Q000150:complications*; D006801:Humans; D008297:Male; D020258:Neurotoxicity Syndromes / Q000175:diagnosis* / Q000209:etiology; D019338:Polypharmacy
keywords: adolescent; brain injury; cognitive reserve; toxic-metabolic encephalopathy