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Acute encephalopathy with bilateral thalamotegmental involvement and a benign course: a case report from Brazil

Regina Maria Papais Alvarenga1, Vanderson Carvalho Neri, Tatiane Mendonça

  • 1Department of Neurology, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil. regina_alvarenga@hotmail.com

BMJ Case Reports
|June 14, 2012
PubMed

Insights

This rare acute postinfectious encephalopathy in children, often fatal, can be treated. A Brazilian child recovered fully after methylprednisolone therapy for severe brain lesions.

Area of Science:

  • Neurology
  • Pediatrics
  • Infectious Diseases

Background:

  • Acute postinfectious encephalopathy is a rare neurological condition typically affecting children.
  • It often follows a respiratory infection and fever, progressing to severe outcomes like coma in most cases.

Observation:

  • A case report details a Brazilian child of African descent presenting with fever, headache, and bilateral visual loss.
  • The child progressed to coma with pyramidal signs and convulsions, exhibiting diffuse, symmetrical thalamotegmental and brainstem lesions on MRI.

Findings:

  • The patient received methylprednisolone, leading to clinical improvement and regression of brain lesions.
  • This resulted in a favorable outcome with no neurological sequelae, which is atypical for this condition.

Implications:

  • This case highlights the potential efficacy of methylprednisolone in treating severe acute postinfectious encephalopathy.
  • The favorable outcome in this atypical presentation suggests that prompt treatment can prevent long-term neurological deficits.

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