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Transient extreme spindles in a case of subacute Mycoplasma pneumoniae encephalitis
S Akaboshi1, T Koeda, S Houdou
1Division of Child Neurology, Faculty of Medicine, Tottori University, Yonago, Japan. akaboshi@grape.med.tottori-u.ac.jp
Abstract:
We describe a 4-year-old boy with delirium including somnolence, irritability, agitation and visual hallucination, associated with Mycoplasma pneumoniae (MP) encephalitis. The MP encephalitis was diagnosed from increased MP-antibody (> 1:1280). Electroencephalography during sleep revealed continuous 9 Hz fast wave activity over the bilateral frontocentral regions, which was thought to represent extreme spindles. These extreme spindles were in parallel with the degree of delirium. Transient extreme spindles have not previously been reported in MP or other encephalitis.
Insights
This study reports a case of Mycoplasma pneumoniae encephalitis in a child, presenting with delirium and unusual EEG findings. Extreme spindles observed during sleep correlated with delirium severity, a novel finding in encephalitis.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Neurophysiology
Background:
- Mycoplasma pneumoniae (MP) encephalitis is a rare neurological complication.
- Delirium in children can manifest with various symptoms including somnolence, irritability, agitation, and visual hallucinations.
Observation:
- A 4-year-old boy presented with acute delirium.
- Diagnosis of MP encephalitis was confirmed by elevated MP-antibody titers.
- Electroencephalography (EEG) revealed continuous 9 Hz fast wave activity (extreme spindles) during sleep.
Findings:
- The observed extreme spindles showed a parallel correlation with the severity of the patient's delirium.
- This association between extreme spindles and delirium severity is a novel observation in MP encephalitis.
- Transient extreme spindles have not been previously documented in MP or other forms of encephalitis.
Implications:
- This case highlights a potential new EEG biomarker for delirium severity in MP encephalitis.
- Further research is needed to understand the mechanism linking extreme spindles and delirium in this condition.
- Recognizing this association may aid in the diagnosis and management of pediatric encephalitis.