Focal seizure associated with human parvovirus B19 infection in a non-encephalopathic child
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Focal seizure associated with human parvovirus B19 infection in a non-encephalopathic child Debopam Samanta, Erin Willis Arkansas, USA
Case report
Background: The incidence of acute symptomatic (at the time of documented brain insult) seizures and single unprovoked seizures are 29-39 and 23-61 per 100 000 per year, respectively. After stabilization of the patient, finding the etiology of the seizure is of paramount importance. A careful history and physical examination may allow a diagnosis without need for further evaluation. Methods: In the literature, severe central nervous system involvement has been reported from human parvovirus B19 infection. We reported a previously healthy 7-year-old girl who presented after an episode of focal seizure. She was afebrile and didn't have any focal neurological abnormalities. She had erythematous malar rash along with reticulating pattern of rash over her both upper extremities. Results: Parvovirus infection was suspected due to the characteristic erythematous malar rash. Serum human parvovirus B19 DNA polymerase chain reaction was positive which was consistent with acute parvovirus infection. Further confirmation of current infection was done with Sandwich enzyme immunoassays showing positive anti-B19 IgM Index (>1.1). IgG index was equivocal (0.9-1.1). Conclusions: We report an extremely rare presentation of non-febrile seizure from acute parvovirus infection in a child without encephalopathy who had an excellent recovery. Timely diagnosis can provide counselling regarding future seizure recurrence risk, curtail expenditure from expensive diagnostic work up and provide additional recommendations about potential risks to a pregnant caregiver. World J Pediatr 2016;12(1):118-120
Author Affiliations: Division of Child Neurology, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA (Samanta D, Willis E) Corresponding Author: Debopam Samanta, MD, 1 Children's Way, Little rock, AR 72202, USA (Tel: 1-434-806-1441; Fax: 1-501-364-6077; Email: [email protected]) doi: 10.1007/s12519-015-0060-0 Online First December 2015 ©Children's Hospital, Zhejiang University School of Medicine, China and Springer-Verlag Berlin Heidelberg 2015. All rights reserved.
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Key words: erythema infectiosum; human parvovirus B19; nonfebrile seizure
Introduction
T
he incidence of acute symptomatic (at the time of documented brain insult) seizures and single unprovoked seizures are 29-39 and 23-61 per 100,000 per year, respectively. [1] In the absence of immediate and obvious provoking etiologies such as head trauma, intracranial infection, brain tumor, hypoglycemia, toxic ingestions, etc., elaborate diagnostic work up is performed utilizing existing practice guidelines. After stabilization of the patient, finding the etiology of the seizure is of paramount importance. A careful history and neurologic examination may allow a diagnosis without need for further evaluation, but the importance of a comprehensive physical examination including other organ system examination cannot be ov
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