Phenytoin-Induced Choreoathetosis in Infancy: Case Reports and a Review

PEDIATRICS ◽  
1983 ◽  
Vol 72 (6) ◽  
pp. 831-834
Author(s):  
K. S. Krishnamoorthy ◽  
E. L. Zalneraitis ◽  
R. S. K. Young ◽  
P. G. Bernad
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Seizure Control ◽  
Case Reports ◽  
Clinical Manifestations ◽  
Pediatric Intensive Care ◽  
Sudden Onset ◽  
Common Causes

Three cases of choreoathetosis which developed during phenytoin therapy in children less than 2 years of age are described. The most striking clinical manifestations included the sudden onset of restlessness and agitation with superimposed choreoathetosis. None of these children had toxic levels of phenytoin in the blood. Discontinuation of phenytoin resulted in prompt cessation of the symptoms. Phenytoin-induced choreoathetosis should be a diagnostic consideration in children with a preexisting CNS insult who manifest violent choreoathetosis during therapy for seizure control. This consideration is especially pertinent in the pediatric intensive care unit, where other more common causes of agitation could be misdiagnosed.

scholarly journals Rescue of four pediatric patients with severe influenza A (H3N2) in Weifang, China

2018 ◽  
Vol 46 (11) ◽  
pp. 4800-4805 ◽  
Author(s):  
Tianhua Li ◽  
Ningning Qi ◽  
Xiaona Gao ◽  
Haili Yu
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Influenza A ◽  
Muscular Atrophy ◽  
Antiviral Treatment ◽  
Clinical Manifestations ◽  
Pediatric Intensive Care ◽  
High Dose ◽  
Severe Influenza

In this report, we summarize our experience of rescuing four children with severe type A H3N2 influenza from January to February 2017 in Weifang People’s Hospital, Shandong Province, China for reference in clinical treatment. Two boys and two girls, ranging in age from 3 months to 6 years, with fever, cough, and asthma, were admitted to the pediatric intensive care unit. All children had severe pulmonary infection with respiratory distress. Three children had myocardial damage, two had liver damage, and one had encephalitis. One child had a history of bronchial asthma and one had severe spinal muscular atrophy. After all four children were admitted to the pediatric intensive care unit, they were provided active and effective organ function support and ventilator-assisted respiration. They were treated with gamma globulin, methylprednisolone, and antibiotics. Three children were treated with anti-influenza drugs and recovered from influenza; one child died even before antiviral treatment intervention on the first day. Definite diagnosis of the cases was through clinical manifestations, supplemented by laboratory tests, such as influenza virus H3N2 rapid antigen detection and nucleic acid detection. Early antiviral therapy, high-dose glucocorticoids and immunoglobulins, and systemic comprehensive rescue might be important for rescuing children with severe influenza A (H3N2).

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