Alvarenga Regina Maria Papais, Neri Vanderson Carvalho, Mendonça Tatiane, Camargo Solange
Department of Neurology, Universidade Federal do Estado do Rio de Janeiro, Rio de Janeiro, Brazil.
BMJ Case Rep. 2011 Jun 30;2011:bcr0920103350. doi: 10.1136/bcr.09.2010.3350.
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.
这种罕见的脑病通常影响儿童，发病前有呼吸道感染及伴有惊厥的发热症状，且可能进展为昏迷。多数情况下预后极差。本病例报告描述了一名非洲裔巴西儿童，出现发热、头痛及双侧黑矇，随后发展为伴有锥体束征及相关惊厥的昏迷。磁共振成像（MRI）显示丘脑被盖区和脑干有弥漫性、对称性病变。给予甲泼尼龙治疗后，患者的临床状况改善，脑部病变消退，患儿目前无神经功能缺损。这是一例急性感染后脑病，累及多个脑结构。治疗后预后良好，无后遗症。该病例具有非典型性，因为一名非洲裔儿童出现双侧视力受累及广泛脑部病变，治疗后却无神经后遗症。文献中未报道过其他类似病例。
