Question of the Week

Question :
Posted On : 20 Jan 2022
An 18 month-old boy presented with fever and recurrent generalized tonic convulsions. He was treated with anticonvulsants, antibiotics, and acyclovir. CT brain findings are consistent with ANEC (acute necrotizing encephalopathy of childhood) with brainstem involvement. He was treated with a course of Methylprednisolone and IVIG. After 2 weeks, clinically he remains in an encephalopathic state. What are the role of steroids and IVIG and when is the practical time to use them in patients with ANEC?
Expert Answer :
ANEC differential includes metabolic and mitochondrial illnesses. Nonconvulsive seizures and central venous thrombosis should be ruled out as causes of persistent coma. Likely his prognosis will be poor, you may try some Ritalin to see if he improves as the reticular system is involved in the brainstem is involved.
Answer Discussion :
Xolelwa Mancoba
within 48 hours
5 months ago
Elijah chambo
Should be 48
5 months ago
should be used within 48 hrs
5 months ago
Azam Rush
IVIG and steroid therapy must be given before antibiotics to minimize inflammatory response in course.
5 months ago
Anna Jackson
48-72 hours of onset
5 months ago

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