Status dystonicus in children: Early recognition and treatment prevent serious complications

This is a retrospective study of all patients presenting to our paediatric unit with status dystonicus (SD) over a period of five years. Anonymous information was collected and a descriptive analysis is made. There were four episodes of SD in three children between 11 and 15 years of age. All children are known to have severe dyskinetic cerebral palsy and presented with an acute or sub-acute deterioration in their symptoms. Symptoms were triggered by infections in three of the four episodes. Early features included frequent and repetitive generalized muscle spasms, poor swallowing, poor sleep, distress and pain. Patients responded to supportive treatment, rehydration, benzodiazepines, baclofen and l-dopa. Intensive care was not necessary in any of the patients and patients made full recovery within 5-14 days. This report shows the value of early recognition and treatment of SD can be successful in preventing serious complications.