Fever producing ballismus in patients with choreoathetosis.

Area of Science:

• Neurology
• Pediatrics
• Movement Disorders

Background:

• Choreoathetoid cerebral palsy (CP) is a movement disorder characterized by involuntary, irregular, and jerky movements.
• Febrile illnesses can precipitate various neurological symptoms in individuals with CP.

Observation:

• Two children with choreoathetoid cerebral palsy presented with intermittent, severe, paroxysmal episodes of ballismus.
• These episodes occurred in response to febrile illnesses and lasted for hours.
• The episodes were challenging to manage, necessitating significant doses of haloperidol or phenytoin.

Findings:

• Ballismus, a type of hyperkinetic movement disorder, was observed in these pediatric CP cases during fever.
• Concurrent electroencephalographic (EEG) recordings were crucial in differentiating these ballismus episodes from fever-triggered seizures.
• The distinct clinical presentation and EEG findings allowed for accurate diagnosis.

Implications:

• This case report highlights a rare manifestation of choreoathetoid cerebral palsy during febrile illnesses.
• It underscores the importance of considering ballismus in the differential diagnosis of movement abnormalities in children with CP during fever.
• The findings emphasize the utility of EEG in distinguishing movement disorders from seizures in this population.