Nervous complications of exanthem subitum

For many years it was generally believed that all convulsions associated with exanthem subitum were febrile in origin. More recently several investigators have suggested that the causative agent of this disease has a selective action on brain tissue aside from the effect of high temperature. In support of this concept are a variety of neurological manifestations sometimes observed during the course of exanthem subitum. These include prolonged and repeated convulsions, hemiparesis, headache, vomiting, bulging fontanelle, vertigo, cervical rigidity, extreme irritability and a reversal of the time of sleep. Abnormalities in the spinal fluid have been reported on a few occasions. By chance the authors observed a case of exanthem subitum that began with a prolonged and severe afebrile convulsion and transient left hemiparesis. Serial electroencephalograms showed a focal lesion with suppression and slowing in the right parietal area. Behavior disorders of brief duration were noted. This case is interpreted as additional evidence of the presence of an encephalitic process. The nature of the cerebral lesion remains unknown. The remote possibility of disturbed behavior in later life deserves consideration.