title: [Refractory status epilepticus presenting as shaken baby syndrome].
abstract: BACKGROUND
  A convulsive status in infants is usually triggered by a febrile syndrome secondary to an intercurrent infection or an infection affecting the central nervous system. Shaken baby syndrome is characterised by its association with bilateral or multifocal haemorrhage, retinal haemorrhage and encephalopathy. Children under one year old are the group with the highest risk, with a maximum incidence reaching a peak between 10 and 16 weeks of age. Intercurrent processes, such as baby colic or febrile syndromes that tend to step up crying, are usually precipitating factors of shaking.
  
  
  METHODS
  We present the cases of two infants who began with a status epilepticus within a context of a febrile syndrome. Imaging tests revealed bilateral subdural haematomas in different stage of progress and bilateral retinal haemorrhages were observed in the fundus oculi of both children.
  
  
  CONCLUSIONS
  In a child with an unspecific febrile process that develops a convulsive status, the professional should suspect, in addition to more usual problems, shaken baby syndrome as a possible causation, above all if the child is under six months old.
authors.affiliation: Hospital Universitario Ramon y Cajal, 28034 Madrid, Espana.
authors.forename: Andrea
authors.initials: A
authors.lastname: Fernandez-Menendez
authors.forename: Raquel
authors.initials: R
authors.lastname: Buenache-Espartosa
authors.forename: Ana
authors.initials: A
authors.lastname: Coca-Perez
authors.forename: Pablo
authors.initials: P
authors.lastname: Morillo-Carnero
authors.forename: Juan
authors.initials: J
authors.lastname: Martinez-San Millan
authors.forename: Gustavo
authors.initials: G
authors.lastname: Lorenzo-Sanz
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D001925:Brain Damage, Chronic / Q000209:etiology; D001988:Bronchiolitis / Q000150:complications / Q000821:virology; D002649:Child Abuse / Q000175:diagnosis*; D020833:Diffuse Axonal Injury / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology; D004351:Drug Resistance; D004832:Epilepsy, Absence / Q000188:drug therapy / Q000209:etiology; D046648:Hematoma, Subdural, Intracranial / Q000209:etiology; D006801:Humans; D007223:Infant; D008297:Male; D018357:Respiratory Syncytial Virus Infections / Q000150:complications; D012166:Retinal Hemorrhage / Q000175:diagnosis / Q000209:etiology; D038642:Shaken Baby Syndrome / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D013226:Status Epilepticus / Q000188:drug therapy / Q000209:etiology*; D014057:Tomography, X-Ray Computed
chemical_list: D000927:Anticonvulsants