Reversible Vegetative State in a Child Due to Drug Reaction with Eosinophilia and Systemic Symptoms

Excerpt

A 15-mo-old developmentally normal girl presented with history of fever, erythematous rash, status epilepticus and persistently altered consciousness of 6 wk duration. She had 2 episodes of unprovoked generalized tonic-clonic seizures at 12 mo of age and was started on oral phenobarbitone. On examination she was febrile, had periorbital puffiness, conjunctivitis, generalized erythroderma (Fig. 1a) with superimposed morbilliform eruptions, fine exfoliation, seborrheic dermatitis, oral cheilitis, alopecia, dystrophic nails, generalized lymphadenopathy and hepatomegaly. Neurological examination showed complete unawareness to surroundings, no meaningful understanding or interaction, no vocalization, cortical visual and hearing impairment, asymmetric quadriparesis (left > right), and continuous choreo-athetoid movements of right upper limb. However her sleep wake cycle and brain stem reflexes were preserved.

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