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Case report
Clinical conundrum: status epilepticus culminating into acute dystonia myoclonus
  1. Madhuri Laxman Khilari1 and
  2. Praveen Kumar Sharma2
  1. 1Neurology, Apollo Hospitals, Hyderabad, Telangana, India
  2. 2Neurology, King George Medical University, Lucknow, Uttar Pradesh, India
  1. Correspondence to Dr Praveen Kumar Sharma; pspgimer{at}gmail.com

Abstract

A 7-year-old child who suffered from symptomatic focal epilepsy as a sequel to perinatal hypoxia used to have frequent seizures. This time she developed prolonged status epilepticus lasting for over 5 hours. She received a treatment in the form of intravenous midazolam and reinitiation of sodium valproate and clobazam that were discontinued previously. Seizures were controlled over a couple of hours, but she remained unresponsive. Later, she developed acute onset dystonia (day 3 post-status epilepticus) and also myoclonic jerks. She presented to us after 3 weeks of onset of these complaints and we considered hypoxic encephalopathy resulting from prolonged status epilepticus or acute encephalitis or non-convulsive status epilepticus. However, acute onset dystonia and periodicity of myoclonic jerks were pointers against it, and on evaluation, she was diagnosed with atypical fulminant subacute sclerosing panencephalitis (SSPE). Knowing the atypical presentations of SSPE is important in planning management and prognostication.

  • epilepsy and seizures
  • neuroimaging
  • infection (neurology)
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Footnotes

  • Twitter @pspgimer

  • Contributors MLK collected data and drafted the manuscript. PKS edited the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Parental/guardian consent obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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