Related Experiment Videos
Acute encephalopathy and intractable seizures in a 10-year-old boy
M E Caceres1, E C de los Reyes, R Khan
1Department of Pediatrics, Robert C. Byrd Health Sciences Center of West Virginia University/Charleston Division, USA.
Insights
A child with Robinow syndrome experienced intractable seizures due to Mycoplasma pneumoniae infection. Prompt treatment with methylprednisolone resolved the encephalopathy and improved EEG activity, highlighting the importance of suspecting CNS Mycoplasma infections.
Area of Science:
- Neurology
- Infectious Disease
- Pediatrics
Background:
- Robinow syndrome is a rare genetic disorder.
- Encephalopathy can present with neurological symptoms like seizures.
- Mycoplasma pneumoniae is a common respiratory pathogen.
Observation:
- A 10-year-old boy with Robinow syndrome presented with intractable seizures, headaches, and dizziness.
- Continuous EEG monitoring revealed persistent epileptiform discharges for 13 days.
- Cerebrospinal fluid and brain biopsy were inconclusive.
Findings:
- Elevated Mycoplasma pneumoniae immunoglobulin G and M titers were detected, doubling during hospitalization.
- High-dose methylprednisolone treatment led to rapid clinical improvement within 12 hours.
- Significant improvement in EEG background activity was observed post-treatment.
Implications:
- Central nervous system Mycoplasma pneumoniae infection should be considered in cases of unexplained encephalopathy, particularly in children.
- Early diagnosis and treatment with corticosteroids may be crucial for managing Mycoplasma-induced neurological complications.
- This case underscores the potential for Mycoplasma pneumoniae to cause severe neurological manifestations beyond typical respiratory symptoms.
Abstract:
We report a 10-year-old child with Robinow's syndrome who had a 2-week history of headaches and dizziness. On the day of admission, he developed a focal onset seizure with rapid secondary generalization. The seizures were intractable despite adequate doses of benzodiazepine, phenytoin, and phenobarbital, requiring a pentobarbital drip. Continuous electroencephalogram (EEG) monitoring showed persistence of the epileptiform discharges for 13 days. Cerebrospinal fluid and brain biopsy studies were unrevealing. Mycoplasma pneumonia titers showed elevation of both immunoglobulins G and M that doubled during the tenth hospital day. High-dose methylprednisolone was begun, and within 12 hours of initiation the patient sat up and began to follow commands appropriately. The overall EEG background markedly improved. Central nervous system Mycoplasma pneumoniae infection should be suspected in patients with an encephalopathy of unclear etiology.