Gastric perforation and critical illness polyneuropathy after steroid treatment in a patient with encephalitis/encephalopathy with transient splenial lesion.
Identifieur interne : 001849 ( Ncbi/Curation ); précédent : 001848; suivant : 001850Gastric perforation and critical illness polyneuropathy after steroid treatment in a patient with encephalitis/encephalopathy with transient splenial lesion.
Auteurs : Mitsuru Ikeno [Japon] ; Shinpei Abe [Japon] ; Hirokazu Kurahashi [Japon] ; Michihiko Takasu [Japon] ; Toshiaki Shimizu [Japon] ; Akihisa Okumura [Japon]Source :
- Brain & development [ 1872-7131 ] ; 2017.
Descripteurs français
- KwdFr :
- Adolescent, Encéphale (imagerie diagnostique), Encéphalite (imagerie diagnostique), Encéphalite (physiopathologie), Encéphalite (rééducation et réadaptation), Encéphalite (traitement médicamenteux), Estomac (), Estomac (imagerie diagnostique), Humains, Mâle, Méthylprednisolone (effets indésirables), Méthylprednisolone (usage thérapeutique), Polyneuropathies (physiopathologie), Polyneuropathies (rééducation et réadaptation), Polyneuropathies (étiologie), Rupture de l'estomac (), Rupture de l'estomac (physiopathologie), Rupture de l'estomac (rééducation et réadaptation), Rupture de l'estomac (étiologie), Stéroïdes (effets indésirables), Stéroïdes (usage thérapeutique).
- MESH :
- effets indésirables : Méthylprednisolone, Stéroïdes.
- imagerie diagnostique : Encéphale, Encéphalite, Estomac.
- physiopathologie : Encéphalite, Polyneuropathies, Rupture de l'estomac.
- rééducation et réadaptation : Encéphalite, Polyneuropathies, Rupture de l'estomac.
- traitement médicamenteux : Encéphalite.
- usage thérapeutique : Méthylprednisolone, Stéroïdes.
- étiologie : Polyneuropathies, Rupture de l'estomac.
- Adolescent, Estomac, Humains, Mâle, Rupture de l'estomac.
English descriptors
- KwdEn :
- Adolescent, Brain (diagnostic imaging), Encephalitis (diagnostic imaging), Encephalitis (drug therapy), Encephalitis (physiopathology), Encephalitis (rehabilitation), Humans, Male, Methylprednisolone (adverse effects), Methylprednisolone (therapeutic use), Polyneuropathies (etiology), Polyneuropathies (physiopathology), Polyneuropathies (rehabilitation), Steroids (adverse effects), Steroids (therapeutic use), Stomach (diagnostic imaging), Stomach (surgery), Stomach Rupture (etiology), Stomach Rupture (physiopathology), Stomach Rupture (rehabilitation), Stomach Rupture (surgery).
- MESH :
- chemical , adverse effects : Methylprednisolone, Steroids.
- diagnostic imaging : Brain, Encephalitis, Stomach.
- drug therapy : Encephalitis.
- etiology : Polyneuropathies, Stomach Rupture.
- physiopathology : Encephalitis, Polyneuropathies, Stomach Rupture.
- rehabilitation : Encephalitis, Polyneuropathies, Stomach Rupture.
- surgery : Stomach, Stomach Rupture.
- chemical , therapeutic use : Methylprednisolone, Steroids.
- Adolescent, Humans, Male.
Abstract
The outcome of mild encephalitis/encephalopathy with reversible splenial lesion (MERS) is favorable whether or not specific treatment is performed. We report a patient with MERS treated with methylprednisolone, complicated by gastric perforation followed by critical illness polyneuropathy. The patient was a 14-year-old male with mildly impaired consciousness and hyponatremia who was treated with methylprednisolone pulse therapy. High fever appeared after methylprednisolone pulse therapy and free air was recognized on an abdomen roentgenogram. Gastric perforation was recognized on emergent endoscopic surgery and omental implantation repair was performed. His consciousness was fully recovered after surgery, whereas he was noted to have motor and sensory impairment of the lower extremities and vesico-rectal disturbance. Nerve conduction studies revealed decreased compound muscle action potentials with preserved motor conduction velocity and decreased sensory nerve action potentials. He was diagnosed as having critical illness polyneuropathy, and bedside physical rehabilitation was initiated. His neurological symptoms resolved within 6months. Our patient highlighted possible serious adverse events associated with steroid treatment for children with MERS.
DOI: 10.1016/j.braindev.2016.10.014
PubMed: 27856098
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<term>Brain (diagnostic imaging)</term>
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<term>Encephalitis (drug therapy)</term>
<term>Encephalitis (physiopathology)</term>
<term>Encephalitis (rehabilitation)</term>
<term>Humans</term>
<term>Male</term>
<term>Methylprednisolone (adverse effects)</term>
<term>Methylprednisolone (therapeutic use)</term>
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<term>Polyneuropathies (physiopathology)</term>
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<term>Steroids (therapeutic use)</term>
<term>Stomach (diagnostic imaging)</term>
<term>Stomach (surgery)</term>
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<term>Stomach Rupture (physiopathology)</term>
<term>Stomach Rupture (rehabilitation)</term>
<term>Stomach Rupture (surgery)</term>
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<term>Encéphale (imagerie diagnostique)</term>
<term>Encéphalite (imagerie diagnostique)</term>
<term>Encéphalite (physiopathologie)</term>
<term>Encéphalite (rééducation et réadaptation)</term>
<term>Encéphalite (traitement médicamenteux)</term>
<term>Estomac ()</term>
<term>Estomac (imagerie diagnostique)</term>
<term>Humains</term>
<term>Mâle</term>
<term>Méthylprednisolone (effets indésirables)</term>
<term>Méthylprednisolone (usage thérapeutique)</term>
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<term>Polyneuropathies (rééducation et réadaptation)</term>
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<term>Rupture de l'estomac</term>
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<term>Polyneuropathies</term>
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<front><div type="abstract" xml:lang="en">The outcome of mild encephalitis/encephalopathy with reversible splenial lesion (MERS) is favorable whether or not specific treatment is performed. We report a patient with MERS treated with methylprednisolone, complicated by gastric perforation followed by critical illness polyneuropathy. The patient was a 14-year-old male with mildly impaired consciousness and hyponatremia who was treated with methylprednisolone pulse therapy. High fever appeared after methylprednisolone pulse therapy and free air was recognized on an abdomen roentgenogram. Gastric perforation was recognized on emergent endoscopic surgery and omental implantation repair was performed. His consciousness was fully recovered after surgery, whereas he was noted to have motor and sensory impairment of the lower extremities and vesico-rectal disturbance. Nerve conduction studies revealed decreased compound muscle action potentials with preserved motor conduction velocity and decreased sensory nerve action potentials. He was diagnosed as having critical illness polyneuropathy, and bedside physical rehabilitation was initiated. His neurological symptoms resolved within 6months. Our patient highlighted possible serious adverse events associated with steroid treatment for children with MERS.</div>
</front>
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