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?
5
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 :
X
Xolelwa Mancoba
Profile
within 48 hours
2 years ago
E
Elijah chambo
Profile
Should be 48
2 years ago
U
unicorn
Profile
should be used within 48 hrs
2 years ago
A
Azam Rush
Profile
IVIG and steroid therapy must be given before antibiotics to minimize inflammatory response in course.
2 years ago
A
Anna Jackson
Profile
48-72 hours of onset
2 years ago




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