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Rare disease
Acute encephalopathy with bilateral thalamotegmental involvement and a benign course: a case report from Brazil
  1. Regina Maria Papais Alvarenga1,2,
  2. Vanderson Carvalho Neri1,
  3. Tatiane Mendonça1,
  4. Solange Camargo2
  1. 1Department of Neurology, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
  2. 2Department of Neurology, Hospital Federal da Lagoa, Rio de Janeiro, Brazil
  1. Correspondence to Professor Regina Maria Papais Alvarenga, regina_alvarenga{at}hotmail.com

Summary

This rare encephalopathy that generally affects children is preceded by a respiratory infection and fever associated with convulsions and may progress to coma. Outcome is catastrophic in most cases. This case report describes a Brazilian child of African descent with fever, cephalea and bilateral amaurosis, who evolved to coma with pyramidal signs and associated convulsions. MRI showed diffuse, symmetrical lesions in the thalamotegmental region and brainstem. Following administration of methylprednisolone, the clinical condition of the patient improved and the brain lesions regressed, leaving the child with no current neurological deficits. This was a case of acute postinfectious encephalopathy, involving various brain structures. Outcome was favourable with no sequelae following therapy. This case was atypical due to the bilateral visual involvement and extensive encephalic lesions in a child of African descent with no neurological sequelae following therapy. No other similar cases have been reported in the literature.

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Footnotes

  • Competing interests None.

  • Patient consent Obtained.