BMJ Case Reports 2015; doi:10.1136/bcr-2014-207796

Neurological adverse effects of methylphenidate may be misdiagnosed as meningoencephalitis

  1. Dinkar Bakshi3
  1. 1Royal Free London NHS Trust, London, UK
  2. 2Medical School, UCL, London, UK
  3. 3East & North Hertfordshire Hospitals NHS Trust, Welwyn Garden City, UK
  1. Correspondence to Dr Luke Blagdon Snell, lukebsnell{at}
  • Accepted 25 May 2015
  • Published 16 June 2015


We present a case of adverse neurological effects of methylphenidate therapy for attention deficit and hyperactivity disorder (ADHD). A 7-year-old boy presented to the emergency department (ED) having developed ataxic gait, orofacial dyskinesias and choreoathetosis of the limbs. The results of all blood investigations, EEG and CT scan of the head were unremarkable. Subsequently, a detailed history revealed he was being treated for ADHD, being started on methylphenidate in the past 3 months. Discontinuation of methylphenidate led to significant and rapid amelioration of neurological adverse effects.

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