Irritability

 
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A 10 months old boy presented with fever for 7 days and excessive crying for 6 days. Fever was accompanied by vomiting initially which subsided within 2 days. Mother had open tuberculosis and was on antituberculous therapy {ATT} for past 1 week. The child was a full term normal delivery on top feeds with normal milestones and immunized for age including BCG. The child was investigated for same and CSF was normal. MRI brain showed frontotemporal enlargement of CSF spaces. The child was put on phenobarbitone and phenytoin and ceftriaxone for these complaints. On examination, child was irritable without any focal neurological deficit. Systemic examination was normal. CBC, liver enzymes and electrolytes were normal.
Expert Opinion :
The child was found to have hyperammonemia.

The hyperammonemia subsided with omission of anticonvulsants.

Answer Discussion :
S
sarah Ashour
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increased in intracranial preesure
5 years ago
K
Khalid Mannan
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2 AED`s!!
5 years ago

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