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    Paediatric rhombencephalitis presenting with bradycardia: a good recovery despite cardiac involvement.

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    Author
    Stokes, V
    Surridge, Jason
    Keyword
    Brain Stem
    Cerebellum
    Emergency Medicine
    Headache
    Migraines
    Paediatrics
    Date
    2021
    
    Metadata
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    Abstract
    Rhombencephalitis is a rare condition, often caused by infection, commonly presenting with myoclonic jerks, ataxia and cranial nerve palsy. Typically, it has a high morbidity and mortality, with worse prognosis associated with cardiopulmonary involvement. Herein, we present the case of a 10-year-old boy, presenting with headache, vomiting, symptomatic bradycardia and rapidly progressing ophthalmoplegia from a sixth nerve palsy, without additional brainstem symptoms. Previously, pericarditis, myocarditis and heart failure have been associated with rhombencephalitis, but not bradycardia. The cause of his rhombencephalitis was presumed viral, but despite extensive screening, the virus responsible was never isolated. Following treatment with intravenous antibiotics and antivirals in a high dependency unit, he recovered well with no neurological deficit on discharge and marked radiological improvement on MRI 4 weeks later. Although rare, rhombencephalitis should be considered in a child presenting with neurological symptoms, particularly alongside a cranial nerve palsy, developing over a rapid time course.
    Citation
    BMJ Case Rep. 2021 Nov 9;14(11):e244189. doi: 10.1136/bcr-2021-244189.
    Publisher
    BMJ
    Type
    Article
    URI
    http://hdl.handle.net/20.500.12904/15026
    Collections
    Paediatrics

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